title: Stent-graft placement in atherosclerotic descending thoracic aortic aneurysms: midterm results.
abstract: OBJECTIVE
  To determine midterm durability and need for reinterventions after stent-graft placement in atherosclerotic descending thoracic aortic aneurysms.
  
  
  METHODS
  Fifty-four patients (38 men; mean age 68 years, range 33-87) underwent stent-graft repair of chronic atherosclerotic aneurysms of the descending thoracic aorta between November 1996 and December 2002. Acute aortic syndromes (type B aortic dissections, perforating ulcers, and traumatic dissections) were excluded from analysis. Two types of commercially available stent-grafts were used (Talent and Excluder).
  
  
  RESULTS
  The primary technical success rate was 94.4%. In-hospital mortality was 3.7% (2/54). No adverse neurological events were encountered. Of 3 (5.6%) early type I endoleaks, 2 (3.7%) required reintervention; the other type I endoleak closed spontaneously. Mean follow-up was 38 months (range 1-72) in the 52 surviving patients. Four (7.7%) type I, 7 (13.5%) type II, and 4 (7.7%) type III endoleaks were seen. Three 3 patients had additional treatment for endoleaks (proximal stenting [type Ia], open thoracoabdominal repair [type Ib], and embolization [type II]). Two of the 3 reinterventions were performed in the first year of follow-up. One additional patient with a type Ia endoleak not suitable for reintervention is under close observation. There were no differences in the number of endoleaks between the 2 types of stent-grafts. Three-year event-free survival was 63%.
  
  
  CONCLUSIONS
  Midterm durability of endovascular stent-graft placement in atherosclerotic descending aortic aneurysms seems promising, as the rate of endoleaks requiring reintervention is acceptably low. In our series, endoleak formation occurred during the first year after stent-graft placement, so close follow-up of patients after aortic aneurysm repair is crucial. Further studies are warranted to evaluate long-term durability of this new treatment modality.
authors.affiliation: Department of Cardiothoracic Surgery, University of Vienna Medical School, Vienna, Austria. bypass@eunet.at
authors.forename: Martin
authors.initials: M
authors.lastname: Czerny
authors.forename: Manfred
authors.initials: M
authors.lastname: Cejna
authors.forename: Doris
authors.initials: D
authors.lastname: Hutschala
authors.forename: Tatjana
authors.initials: T
authors.lastname: Fleck
authors.forename: Thomas
authors.initials: T
authors.lastname: Holzenbein
authors.forename: Maria
authors.initials: M
authors.lastname: Schoder
authors.forename: Johannes
authors.initials: J
authors.lastname: Lammer
authors.forename: Daniel
authors.initials: D
authors.lastname: Zimpfer
authors.forename: Marek
authors.initials: M
authors.lastname: Ehrlich
authors.forename: Ernst
authors.initials: E
authors.lastname: Wolner
authors.forename: Martin
authors.initials: M
authors.lastname: Grabenwoger
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017545:Aortic Aneurysm, Thoracic / Q000150:complications / Q000601:surgery*; D001161:Arteriosclerosis / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome