Endovascular repair for thoracic aortic pathologies--early and midterm results.
OBJECTIVE
To assess the early and midterm results of endovascular stent graft repair in patients with thoracic aortic pathologies.


METHODS
Between March 2000 and December 2005, 44 consecutive patients undergoing endovascular repair for 45 thoracic aortic lesions were studied. Follow-up protocol includes regular clinical examination and computed tomographies.


RESULTS
There were 37 men and 7 women with a median age of 59 years at operation (range, 26-90). The pathologies consisted of 15 thoracic aortic aneurysms, nine pseudoaneurysms, 16 thoracic aortic dissections, and five thoracic aortic injuries. Successful deployment of the endovascular stent grafts with complete sealing of the pathology were achieved in all but one patient who had the procedure abandoned as a result of access difficulty, giving a technical success of 98%. The median hospital stay was 7 days (range, 3-196), with no hospital death nor paraplegia. The median follow-up was 25 months (range, 0-86). There were eight follow-up deaths, two of which were thoracic aortic pathology related (both patients had aortoesophageal fistulae). There were three other clinical failures: distal attachment endoleak in a patient with thoracic aortic aneurysm, one enlarging and one newly developed dissecting thoracic aortic aneurysm despite endografting. The cumulative freedom from clinical failure and failure free survival were 90% and 75% at 18 months respectively.


CONCLUSIONS
Endovascular stent graft repair is a feasible option in thoracic aortic pathologies with promising early and midterm results.
Ting
Albert C W
AC
Division of Vascular Surgery, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, China.
Cheng
Stephen W K
SW
Ho
Pei
P
Chan
Yiu Che
YC
Poon
Jensen T C
JT
Cheung
Grace C Y
GC