Long-term results of flow reversal and thromboexclusion method for thoracic aortic aneurysm.
BACKGROUND
The long-term results of flow reversal and thromboexclusion for the elimination of a thoracic aortic aneurysm were studied.


METHODS
We monitored the posttreatment course in 10 patients with a thoracic aortic aneurysm who underwent thromboexclusion between 1981 and 1990. All patients had comorbid factors, such as renal failure, myocardial infarction, or respiratory dysfunction, and the entire descending thoracic aorta was involved in all. One patient with impending rupture underwent permanent occlusion of both the proximal and distal aortas, and the remaining 9 patients underwent proximal aortic occlusion only.


RESULTS
Two patients died within 30 days of operation. Postoperative cerebral infarction occurred in 1 patient, possibly as the result of the release of atheroma emboli at the time of permanent clamping. Incomplete paraplegia occurred in 1 patient 15 months postoperatively. Two patients died as the result of comorbid conditions 3 and 39 months after operation; 1 patient died as the result of penetration of the lung by the permanent clamp 12 months after operation. An aortic aneurysm recurred in 4 patients, and 3 of them died of aneurysmal rupture 50,55, and 63 months after operation, respectively. The fourth patient with aneurysmal recurrence underwent reoperation and is alive 124 months postoperatively. Another patient is alive without recurrence 140 months postoperatively.


CONCLUSIONS
Because of the postoperative complications and the risk of aneurysm recurrence, the thromboexclusion method should be used only in patients with an infected aneurysm or in those with a severely morbid condition.
Urayama
H
H
First Department of Surgery, Kanazawa University School of Medicine, Japan.
Ohtake
H
H
Watanabe
Y
Y
D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D001019:Aortic Rupture / Q000401:mortality; D001807:Blood Vessel Prosthesis; D015897:Comorbidity; D003250:Constriction; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D011859:Radiography; D012008:Recurrence; D012307:Risk Factors; D013997:Time Factors