Endovascular repair of the descending thoracic aorta: mid-term results and evaluation of magnetic resonance angiography.
OBJECTIVE
The endoluminal stent-grafting represents an alternative to surgery in the treatment of lesions of the descending thoracic aorta. The purpose of the present study was to evaluate the mid-term results of the Talent stent-graft in the different indications of aortic disease and the use of magnetic resonance angiography (MRA) in the diagnosis of complications.


METHODS
Over a 3-year period, 23 patients with a high surgical risk and presenting a localized lesion of the descending thoracic aorta had an implantation of a Talent stent-graft. Indications were degenerative aneurysm (n=13), false aneurysm (n=7) and penetrating atherosclerotic ulcer (n=3). The feasibility of the endovascular treatment and sizing of the aorta and stent-grafts were determined pre-operatively by MRA and intraoperative angiography. Immediate and mid-term technical and clinical success were assessed by clinical and MRA follow-up.


RESULTS
Endovascular treatment was completed successfully in all patients with no conversion to open repair. There was no intraoperative mortality. The mean operative time was 38+/-7 min. Primary success rate was 100%. We didn't have perioperative mortality. The mean follow-up period was 15+/-5 months. The survival rate was 97% (n=22). Regression of the aneurysmal size was observed in 70% (n=16). MRA diagnosed 3 over 4 postoperative endoleaks that were not diagnosed with the CT-scan, and did not interfere with the nitinol structure of the stent-graft.


CONCLUSIONS
Endovascular treatment of the various localized diseases of the descending thoracic aorta is a promising, feasible, alternative technique to open surgery in well selected patients. MRA is well adapted to diagnose postoperative endoleaks.
Farhat
F
F
Department of Cardiovascular Surgery, Louis Pradel Hospital, Claude Bernard University INSERM E0226, Bron, France. fadi.farhat@chu-lyon.fr
Attia
C
C
Boussel
L
L
Staat
P
P
Revel
D
D
Douek
P
P
Villard
J
J
D000368:Aged; D000369:Aged, 80 and over; D017541:Aneurysm, False / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D001013:Aorta, Thoracic / Q000473:pathology / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D050197:Atherosclerosis / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D015607:Stents; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome; D014456:Ulcer / Q000175:diagnosis / Q000209:etiology / Q000601:surgery