title: Endovascular repair of localized pathological lesions of the descending thoracic aorta: midterm results.
abstract: The endoluminal stent-graft represents an attractive and a less invasive technique for treatment of various diseases of the descending thoracic aorta. The purpose of this study was to evaluate the Talent endovascular stent-graft for the treatment of various localized diseases of the descending thoracic aorta. Over a 3-year period, Talent thoracic endografts were placed in 40 patients with a high surgical risk, presenting a localized lesion of the descending thoracic aorta: degenerative aneurysm (n = 13), acute traumatic rupture (n = 11), acute Stanford type B aortic dissection (n = 6), false aneurysm (n = 7), and penetrating atherosclerotic ulcer (n = 3). Fifteen patients (37.5%) were treated as emergencies. The feasibility of endovascular treatment and sizing of the aorta and stent-grafts were determined preoperatively by magnetic resonance angiography (MRA) and intraoperative angiography. Immediate and mid-term technical and clinical success was assessed by clinical and MRA follow-up. Endovascular treatment was completed successfully in all 40 patients, with no conversion to open repair or intraoperative mortality. The mean operative time was 37.5 +/- 7 min. The overall 30-day mortality rate was 10% (n = 4), all in emergency cases, for causes not related to the endograft. The primary technical success was 92.5%. The mean follow-up period was 15 +/- 5 months. The survival rate was 95% (n = 35). Diminution of the aneurismal size was observed in 47.5% (n = 19). We conclude that 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.
authors.affiliation: Department of Cardiovascular Surgery, University Hospital Louis Pradel, Lyon, France.
authors.forename: Cherif
authors.initials: C
authors.lastname: Attia
authors.forename: Jacques
authors.initials: J
authors.lastname: Villard
authors.forename: Loic
authors.initials: L
authors.lastname: Boussel
authors.forename: Fadi
authors.initials: F
authors.lastname: Farhat
authors.forename: Jacques
authors.initials: J
authors.lastname: Robin
authors.forename: Didier
authors.initials: D
authors.lastname: Revel
authors.forename: Philippe
authors.initials: P
authors.lastname: Douek
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000175:diagnosis / Q000601:surgery; D017541:Aneurysm, False / Q000175:diagnosis / Q000601:surgery; D017130:Angioplasty; D001013:Aorta, Thoracic / Q000293:injuries / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000601:surgery; D001018:Aortic Diseases / Q000175:diagnosis / Q000601:surgery*; D001019:Aortic Rupture / Q000175:diagnosis / Q000601:surgery; D001027:Aortography; D050197:Atherosclerosis / Q000175:diagnosis / Q000601:surgery; D001807:Blood Vessel Prosthesis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011474:Prosthesis Design; D015607:Stents; D014456:Ulcer / Q000175:diagnosis / Q000601:surgery; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000601:surgery