Complications after endovascular treatment of thoracic aortic aneurysms.
OBJECTIVE
To retrospectively determine the value of stent-graft repair of descending thoracic aortic aneurysms by analyzing the results and complications.


METHODS
From May 1997 to July 2002, 45 patients (33 men; mean age 69 years, range 31-88) received endovascular treatment for thoracic aortic aneurysms. In 11 patients, emergency treatment was necessary for a contained rupture. The medical records of these patients were reviewed to gather data on the procedures, immediate results, complications, mortality, and survival in follow-up.


RESULTS
In all cases, the stent-grafts were successfully implanted. In 15 (33%) cases, the subclavian artery was covered by the stent-graft without complications. There was no paraparesis/paraplegia; 2 (4.4%) patients suffered a stroke intraoperatively. The in-hospital mortality was 2.2% (n=1); 3 (6.7%) patients died within 30 days. Primary endoleaks occurred in 8 (17.8%) cases. Procedural success (technical success without endoleak or death) was 80% (93.3% after primary endoleak repair). During follow-up, 2 (4.4%) secondary endoleaks developed. All endoleaks were treated successfully or sealed spontaneously (n=2). At a mean 24-month follow-up (range 1-62), 84% of patients were alive.


CONCLUSIONS
The endovascular treatment of thoracic aortic aneurysms appears to be safe and effective, with lower morbidity and mortality than in conventional open operations. For these reasons, endovascular treatment should be administered whenever possible.
Scharrer-Pamler
Reinhard
R
Department of Thoracic and Vascular Surgery, University Hospital Ulm, Germany. reinhard.pamler@medizin.uni-ulm.de
Kotsis
Thomas
T
Kapfer
Xaver
X
Görich
Johannes
J
Orend
Karl-Heinz
KH
Sunder-Plassmann
Ludger
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017545:Aortic Aneurysm, Thoracic / Q000401:mortality / Q000628:therapy*; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D011475:Prosthesis Failure; D012189:Retrospective Studies; D015607:Stents; D016019:Survival Analysis; D016896:Treatment Outcome