title: Mid-term results after endovascular stent-graft placement due to penetrating atherosclerotic ulcers of the thoracic aorta.
abstract: BACKGROUND
  To determine mid-term durability of endovascular stent-graft placement in patients with penetrating atherosclerotic ulcers (PAU) involving the thoracic aorta and to identify risk factors for death as well as early and late cardiovascular events.
  
  
  METHODS
  From 1997 to 2006, 27 patients (mean age 66 yrs) presented with PAU (rupture n=7). Mean numeric EuroScore was 11 and mean logistic EuroScore was 35. Median follow-up was 42 (10-86) months, being complete in all patients. Outcome variables included death and occurrence of early and late cardiovascular events.
  
  
  RESULTS
  In-hospital mortality was 11%. Primary success rate was 100%. Actuarial survival rates at 1, 3 and 5 years were 93%, 78% and 70%, respectively. Hemodynamic instability (HR 2.5, 2.1-3.9; p=0.034) as well as logistic EuroScore (HR 2.8, 2.4-4.3; p=0.019) was identified as independent predictor of early and late cardiovascular events.
  
  
  CONCLUSIONS
  Endovascular stent-graft placement in patients with PAU is an effective palliation for a life-threatening sign of a severe systemic process. Hemodynamic instability at referral and a high preoperative risk score predict adverse outcome. During mid-term follow-up, patients are mainly limited by sequelae of their underlying disease.
authors.affiliation: Department of Cardiothoracic Surgery, University of Vienna Medical School, Vienna, Austria.
authors.forename: Roman
authors.initials: R
authors.lastname: Gottardi
authors.forename: Daniel
authors.initials: D
authors.lastname: Zimpfer
authors.forename: Martin
authors.initials: M
authors.lastname: Funovics
authors.forename: Maria
authors.initials: M
authors.lastname: Schoder
authors.forename: Johannes
authors.initials: J
authors.lastname: Lammer
authors.forename: Ernst
authors.initials: E
authors.lastname: Wolner
authors.forename: Martin
authors.initials: M
authors.lastname: Czerny
authors.forename: Michael
authors.initials: M
authors.lastname: Grimm
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014456:Ulcer / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*