Stent-grafting of the thoracic aorta: feasibility and early results in acute and chronic lesions.
OBJECTIVE
Conventional surgery of the thoracic aorta is frequently associated with significant mortality and morbidity. Here we present treatment of surgical pathologies of the thoracic aorta using a less invasive endovascular approach.


METHODS
From January 2000 to May 2004, 51 patients (mean age 62.7 +/- 12.8 years, 36 men) underwent endovascular repair of thoracic aortic lesions in our institution. All patients underwent computed tomography scan at discharge, 6 and 12 months and annually thereafter. Clinical follow-up was carried out by outpatient clinic visit or by telephone contact with the patients or their referring physicians. Mean follow-up was 15.8 months.


RESULTS
The 30-day mortality rate was 3.8%, one death in the group of chronic (1.9%) and one in the group of acute lesion (1.9%). The survival rate in the follow-up period was 92.4% at 6 months. Computed tomography angiography confirmed exclusion of the lesion in 25 out of 27 chronic patients, whereas type I and II endoleaks were detected in two patients treated with a secondary procedure. In addition, two patients with an acute type B aortic dissection presented with early endoleaks. The overall rate of complications was 10%. No other endoleaks or deaths were observed at later follow-up.


CONCLUSIONS
The early and mid-term results of endovascular stent-grafting for the treatment of chronic and acute thoracic aortic diseases showed a good outcome and low rate of complications. Stent-grafting of the thoracic aorta is still an investigational procedure that needs further validation.
Livi
Ugolino
U
Department of Cardiopulmonary Sciences, General Hospital S. Maria della Misericordia, Udine, Italy.
Piccoli
Gianluca
G
Ciccarese
Giovanni
G
Vendramin
Igor
I
Frassani
Romeo
R
Vit
Alessandro
A
Sponza
Massimo
M
Marzio
Andrea
A
Gonano
Nevio
N
Gasparini
Daniele
D
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000473:pathology / Q000601:surgery; D001013:Aorta, Thoracic / Q000293:injuries / Q000473:pathology / Q000601:surgery*; D001018:Aortic Diseases / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D002908:Chronic Disease; D003324:Coronary Artery Disease / Q000150:complications; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D015607:Stents; D016896:Treatment Outcome; D014456:Ulcer / Q000209:etiology / Q000473:pathology / Q000601:surgery; D018084:Ultrasonography, Interventional