Mid-term results after endovascular stent-grafting of descending aortic aneurysms in high-risk patients.
OBJECTIVE
To analyze our experience with endovascular stent-grafting of descending aortic aneurysms in high-risk patients.


METHODS
Nineteen patients underwent endovascular stent-graft repair of descending aortic aneurysms using the Talent Stent Graft System (Medtronic). All patients were considered high-risk for open surgical repair due to their age, requirement for emergency surgery, and comorbidities. Computed tomography and/or MR tomography were performed at 3, 6 and 12 months postoperatively and thereafter every 12 months.


RESULTS
Secondary technical success was 100%. Thirty-day mortality was 5%. Incidence of postoperative stroke and paraplegia were 5% each. One patient required a second stent-graft due to a type I endoleak during the same hospital stay (primary technical success 95%). All patients have been followed for a median of 20 months. No migration, wire fractures or endoleak appeared during follow-up.


CONCLUSIONS
Endovascular stent-grafting had a low 30-day mortality and morbidity in high-risk patients. One patient developed an aortoesophageal fistula 40 days after stent implantation. Stent-graft repair is a valuable supplement to surgical therapy in high-risk patients.
Brandt
Michael
M
Department of Cardiovascular Surgery, University Hospital Schleswig-Holstein, Kiel Campus, Arnold-Heller-Strasse 7, 24105 Kiel, Germany. mbrandt@kielheart.uni-kiel.de
Walluscheck
Knut P
KP
Jahnke
Thomas
T
Attmann
Tim
T
Heller
Martin
M
Cremer
Jochen
J
Müller-Hülsbeck
Stefan
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D001019:Aortic Rupture / Q000000981:diagnostic imaging / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011859:Radiography; D012307:Risk Factors; D015607:Stents; D015996:Survival Rate