title: [Endovascular repair of descending thoracic aortic aneurysm: preliminary experience].
abstract: OBJECTIVE
  To report an initial experience with the endovascular repair of descending thoracic aortic aneurysm (DTAA).
  
  
  METHODS
  Endoprostheses were placed into 41 patients with DTAA between January 2001 and July 2007 which were retrospectively analyzed. The preliminary right-left carotid and left carotid-subclavian bypass was performed in 4 cases in which the distances from the proximal aneurysm to the origin of the left common carotid artery were no longer than 15 mm. EVAR was conducted 1 week after the bypass or immediately.
  
  
  RESULTS
  All stent grafts were deployed in proper position. There were two deaths (4.9%) during perioperative period, resulting from multiorgan failure and acute cardiac infarction, respectively. Eighteen endoleaks occurred immediately after EVAR (43.9%), four disappeared after balloon dilatation. There were two acute renal insufficiencies (4.9%), one requiring hemodialysis for more than 30 days. Follow-up, which ranged from 1 to 60 months [median, (18.6 +/- 4.2) months] was carried out in 26 patients (63.4%). Type-I endoleak and type-III endoleak were detected in two patients in 4 years and 2 years after EVAR, might because of migration, and were corrected using another stent-graft each. Two patients died of other diseases during follow-up. Complete thrombosis of the thoracic aneurysm sac with no late migration or endoleaks was revealed on CT at 3 months postoperatively in the remaining patients. The decrease in maximal aneurysm diameter was 0-22 mm [median, (8.3 +/- 4.5) mm] and the prosthetic vascular grafts in four patients with preliminary carotid subclavian bypass surgery were patent during the follow-up period.
  
  
  CONCLUSIONS
  The treatment of descending thoracic aortic aneurysm with an endovascular approach is feasible with less trauma, quick recovery and less complications. It may offer the best means of therapy for high risk patients.
authors.affiliation: Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Yu-qi
authors.initials: YQ
authors.lastname: Wang
authors.forename: Wei-guo
authors.initials: WG
authors.lastname: Fu
authors.forename: De-bing
authors.initials: DB
authors.lastname: Shi
authors.forename: Bin
authors.initials: B
authors.lastname: Chen
authors.forename: Da-qiao
authors.initials: DQ
authors.lastname: Guo
authors.forename: Xin
authors.initials: X
authors.lastname: Xu
authors.forename: Jun-hao
authors.initials: JH
authors.lastname: Jiang
authors.forename: Jue
authors.initials: J
authors.lastname: Yang
authors.forename: Zhen-yu
authors.initials: ZY
authors.lastname: Shi
authors.forename: Zhi-hui
authors.initials: ZH
authors.lastname: Dong
authors.forename: Ting
authors.initials: T
authors.lastname: Zhu
authors.forename: Wei-miao
authors.initials: WM
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D012189:Retrospective Studies; D016896:Treatment Outcome