Long-term results of endoluminal grafting for descending thoracic aortic aneurysms.
OBJECTIVE
This paper describes the long-term results of endoluminal grafting (EG) for the treatment of descending thoracic aortic aneurysms (dTAA).


METHODS
Until July 2004, EG for dTAA has been applied in 45 cases (male/female, 29/16, 49-86 years old, mean age 67 years old). Locations included the proximal dTAA in 24 cases, and middle or distal dTAA in 21 cases. The stent-grafts (SGs) were constructed of Gianturco Z-stents covered with woven polyester grafts.


RESULTS
Deployment of the SGs was successful in 43 of 45 cases (96%) and complete thrombosis of the aneurysm was achieved in 39 cases (87%). Six minor endoleaks (13%), one migration (2%) and one conversion to surgery (2%) occurred. There was no instance of paraplegia nor hospital death. Over a mean 48 month follow-up (range 3 to 90), there were three persistent endoleaks (6%), four secondary endoleaks (8%), one breakage of wire frame (2%). Four cases were converted to open surgery due to secondary endoleak. There were two aneurysmal ruptures at the site where EG was not performed. The cumulative survival rate was 95.6 +/- 4.4% at 12 months, 85.7 +/- 5.4% at 24 months, and 82.4 +/- 6.1% at 36 and 60 months.


CONCLUSIONS
These results demonstrated that EG is safe and effective in selected dTAA patients. Improvements in patients selection, surgical techniques and equipment will reduce EG related complications and conversion to open repair over the course of the evaluation.
Midorikawa
Hirofumi
H
Cardiovascular Center, Fukushima Daiichi Hospital, Kitasawamata, Japan.
Ogawa
Tomohiro
T
Satou
Kouichi
K
Hoshino
Shunichi
S
Takase
Shinya
S
Yokoyama
Hitoshi
H
D000368:Aged; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D015607:Stents; D016896:Treatment Outcome