title: Successful endovascular stent-grafting for thoracic aortic aneurysms in systemic lupus erithematosus. Report of 2 cases and review of the literature.
abstract: Systemic lupus erythematosus (SLE) is frequently associated with cardiovascular manifestations but rarely complicated with aortic disease, and surgical treatment is often complicated with later anastomotic dehiscence. We report successful endovascular stent-graft placement (EVSGP) as an alternative to conventional treatment of the aortic aneurysm in patients with SLE and review of the literature. Clinical cases included a 58-year-old woman with a saccular aneurysm of the distal aortic arch and a 52-year-old woman who had the aortic dissection in the whole descending thoracic aorta. Both patients underwent placement of the stent-graft in the diseased aorta through the iliac artery and received steroid perioperatively. Mortality was compared between surgical and medical treatment in the reported 39 cases of SLE associated with aortic aneurysm. Both patients were successfully treated by EVSGP and no inflammatory signs were seen after the procedure. There were no recurrence in the short follow-up period (up to 23 and 15 months after the procedure). In review of the literature, operative mortality (13.6%) was superior to that in patients receiving medical treatment only (53.3%), but two of 19 operative survivors died of rupture afterward. EVSGP can be a useful alternative to conventional treatment of the aortic aneurysm in patients with SLE, although it lacks the support of long-term follow-up data currently.
authors.affiliation: Department of Cardiovascular Surgery, Hokkaido University School of Medicine, Sapporo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Kunihara
authors.forename: S
authors.initials: S
authors.lastname: Sasaki
authors.forename: T
authors.initials: T
authors.lastname: Nishibe
authors.forename: F
authors.initials: F
authors.lastname: Akimaro Kudo
authors.forename: N
authors.initials: N
authors.lastname: Shiiya
authors.forename: T
authors.initials: T
authors.lastname: Murashita
authors.forename: K
authors.initials: K
authors.lastname: Yasuda
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000188:drug therapy; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D011379:Prognosis; D015607:Stents; D013997:Time Factors
chemical_list: D000305:Adrenal Cortex Hormones