title: Midterm results of endovascular treatment of atherosclerotic aneurysms of the descending thoracic aorta.
abstract: OBJECTIVE
  We sought to determine the midterm results of endovascular repair of atherosclerotic aneurysms of the thoracic descending aorta by using second-generation, commercially available stent grafts.
  
  
  METHODS
  Between 1996 and 2005, 45 patients (mean age, 68 +/- 11 years) with aneurysms of the descending thoracic aorta underwent endovascular repair. Aortic dissections, penetrating ulcers, and traumatisms were excluded. The mean follow-up was 24.7 +/- 21.6 months (maximum, 6.7 years).
  
  
  RESULTS
  No patients died, and no conversion to surgical intervention was required during the procedures. Three (6.7%) patients died during the first month, and 6 (14.7%) died later on. The main complications were strokes (13.3%), vascular access complications (8.9%), aortic complications (6.6%), paraplegia (4.4%), and sudden deaths (4.4%). Nineteen (42%) primary endoleaks were encountered: 3 required reinterventions, 15 spontaneously thrombosed, and 1 patient died. Except for 2 sudden unexplained deaths, no aortic complications were observed after 1 month. Actuarial survival estimates at 1, 3, and 5 years were 87.6% +/- 5.3%, 76.9% +/- 7.4%, and 70.6% +/- 9.2%, respectively. Actuarial freedom from death related to the treated aortic disease was 94.3% +/- 4.0%, 94.3% +/- 4.0%, and 86.4% +/- 8.4% at 1, 3, and 5 years, respectively. Aspirin status of greater than 3 (P = .005), high aortic diameter (P = .007), and long covered lengths (P = .02) were determinant for mortality. Actuarial freedom from complication was 62.6% +/- 7.7%, 58.9% +/- 8.1%, and 58.9% +/- 8.1% at 1, 3, and 5 years, respectively. The location of the aneurysm (P = .05) and a high aortic diameter (P = .04) were both determinants for endoleaks.
  
  
  CONCLUSIONS
  Stent grafting of atherosclerotic aneurysm of the thoracic descending aorta is safe and effective. Further studies are mandatory to determine the most relevant indications and the long-term efficacy of such treatment.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Rangueil University Hospital, Toulouse, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Marcheix
authors.forename: Camille
authors.initials: C
authors.lastname: Dambrin
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Bolduc
authors.forename: Catherine
authors.initials: C
authors.lastname: Arnaud
authors.forename: Christophe
authors.initials: C
authors.lastname: Cron
authors.forename: Lucy
authors.initials: L
authors.lastname: Hollington
authors.forename: Antoine
authors.initials: A
authors.lastname: Mugniot
authors.forename: Philippe
authors.initials: P
authors.lastname: Soula
authors.forename: Mehdi
authors.initials: M
authors.lastname: Bennaceur
authors.forename: Valérie
authors.initials: V
authors.lastname: Chabbert
authors.forename: Pierre
authors.initials: P
authors.lastname: Massabuau
authors.forename: Philippe
authors.initials: P
authors.lastname: Otal
authors.forename: Alain
authors.initials: A
authors.lastname: Cérène
authors.forename: Hervé
authors.initials: H
authors.lastname: Rousseau
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic; D017545:Aortic Aneurysm, Thoracic / Q000209:etiology / Q000601:surgery*; D050197:Atherosclerosis / Q000150:complications*; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D016896:Treatment Outcome