Thoracic aortic stents: a combined solution for complex cases.
OBJECTIVE
The combination of endovascular and standard surgical techniques may facilitate the management of complex aortic disease although the long-term durability of this approach needs to be confirmed.


METHODS
A retrospective review of our experience in the treatment of patients with complex aortic pathology using a combined endovascular and surgical approach.


METHODS
Between 1998 and 2001, 27 patients with thoracic aortic aneurysm underwent stent-graft implantation. Eight required combined endovascular and surgical procedure because of complex pathology. In 3 cases, combined repair was carried out for a concomitant abdominal aortic aneurysm or aorto-iliac-femoral occlusive disease. In the other 5 cases, vessel relocation was performed to obtain safe landing zones: left subclavian artery to left carotid artery translocation in 3 patients, celiac trunk to superior mesenteric artery translocation in one and aorto-celiac-mesenteric bypass grafting in one.


RESULTS
One of the 8 patients died on 12th post-operative day of intestinal bleeding and bowel infarction. No neurological sequelae were reported. The other patients are currently well at 11 months mean follow-up time.


CONCLUSIONS
Simultaneous surgical and endovascular procedure is a feasible and may be a valuable adjunct to the treatment of complex aortic and peripheral vessel anatomy.
Saccani
S
S
Cattedra e Divisione di Cardiochirurgia, Università degli Studi, Parma, Italy.
Nicolini
F
F
Beghi
C
C
Marcato
C
C
Uccelli
M
M
Larini
P
P
Budillon
A M
AM
Agostinelli
A
A
Gherli
T
T
D000328:Adult; D000368:Aged; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D015607:Stents; D016896:Treatment Outcome