Endoluminal stent-graft placement for acute rupture of the descending thoracic aorta.
OBJECTIVE
To investigate the results of endovascular stent-graft placement for the treatment of acute perforating lesions of the descending thoracic aorta.


RESULTS
A total of 31 consecutive patients underwent interventional treatment for perforating lesions of the descending aorta. In 21 cases (group A), the aortic perforation was due to rupture of a descending thoracic aneurysm or dissection, whereas 10 patients (group B) were treated for traumatic transection of the descending aorta. A total of 42 endoprostheses were implanted. The implantation procedure was successful in all cases without peri-interventional complications. In one case, implantation of a second endoprosthesis became necessary due to type I endoleak. Overall, the 30-day mortality was 9.7%. As all three deaths occurred in group A, the mortality rate in this group was 14.3% versus 0% in group B. Similarly, postinterventional complications were more prevalent, with 28.6% in group A (renal failure n = 4; stroke n = 2) versus 10.0% in group B (renal failure n = 1). No paraplegia and no further deaths or ruptures occurred during follow-up (mean 17 months).


CONCLUSIONS
Interventional stent-graft placement is an effective treatment option for the emergency repair of descending aortic perforations.
Scheinert
D
D
Department of Medicine/Cardiology, Clinical and Interventional Angiology, University of Leipzig - Heart Centre, Strümpellstr. 39, 04289 Leipzig, Germany. dierk.scheinert@mx.de
Krankenberg
H
H
Schmidt
A
A
Gummert
J F
JF
Nitzsche
S
S
Scheinert
S
S
Bräunlich
S
S
Sorge
I
I
Krakor
R
R
Biamino
G
G
Schuler
G
G
Mohr
F W
FW
D058186:Acute Kidney Injury / Q000209:etiology; D000368:Aged; D000369:Aged, 80 and over; D017545:Aortic Aneurysm, Thoracic / Q000401:mortality / Q000628:therapy*; D001019:Aortic Rupture / Q000401:mortality / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D020521:Stroke / Q000209:etiology; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome