[Outcome of endovascular stent graft placement in patients with acute thoracic aortic syndromes].
OBJECTIVE
To evaluate the outcome of endovascular stent graft placement in patients with acute thoracic aortic syndromes.


METHODS
Emergency stent-graft implantations were performed in 57 patients with acute thoracic aortic syndromes from May 2001 to December 2005 (45 Stanford B aortic dissections, 9 acute penetrating aortic ulcers or pseudoaneurysms. 3 traumatic thoracic aneurysms). The clinical data, efficacy and follow-up results were analyzed.


RESULTS
Procedures were successful in all patients. Type I endoleaks were evidenced in 5 patients and ascending aortic dissection occurred in 1 patient during operation, 5 patients with acute penetrating aortic ulcer complicating with coronary artery disease received successful PCI immediately post endovascular stent graft placement. Adynamia in extremities occurred in 1 patient and recovered two days later post anisodamine and mcnicol treatments. Left vertebral artery ischemia was found in 1 patient due to coated subclavian artery by stent-graft and the patient recovered spontaneously after two days lethargy without special treatment. The mean ICU time after surgery was 3.5 days (1 - 8 days) and the mean hospitalization time was 10 days. The mean follow-up time was 25.30 +/- 13.1 months (1 - 47 months). Two patients died within 30 days after operation, 1 patient died of rupture of the ascending aortic dissection (7 days post operation), 1 patient died of acute renal failure at the 2nd day post operation. One patient died of empsyxis 3 months after procedure, 1 patient died at the 4th month post procedure for unknown reason, 1 patient received second stent-graft implantation because of a newly formed endoleak at the proximal end of the stent-graft, 5 patients received second stent-graft implantation because of newly formed leaks at the remote end of the stent-graft. No paraplegia or stent migration or stenosis was observed during the follow up period. Total mortality during hospitalization and follow-up was 7.0%.


CONCLUSIONS
Patients with acute thoracic aortic syndrome could be effectively and safely treated by coated stent-graft endovascular placement.
Li
Zhi-zhong
ZZ
Emergency Center for Heart, Lung and Vessel Diseases, Beijing Anzhen Hospital, Capital University of Medical Sciences, Beijing 100029, China. lzzeagle2@sina.com
Xu
Shang-dong
SD
Liu
Tong
T
Tao
Ying
Y
Wang
Su
S
Ma
Lin-an
LA
Huang
Fang-jiong
FJ
Sun
Yan-qing
YQ
Zhang
Zhao-guang
ZG
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000601:surgery*; D017541:Aneurysm, False / Q000601:surgery*; D001013:Aorta, Thoracic; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D013577:Syndrome