title: [Long-term outcomes of thoracic endovascular aortic repair with homemade stent-grafts].
abstract: We reviewed our experience with homemade stent-grafts in the repair of thoracic aortic lesions. The objective of this study was to assess the long-term outcomes of this therapy. From 1999 to 2008, homemade stent-grafts were inserted in 94 patients with various thoracic diseases. The endoprostheses were stainless steel Z-stents covered with polyester graft and were custom designed for each patient. Placement of the stent-grafts was technically successful in 85 of the 94 patients (90%). Within 30 days after the treatment, 4 patients died, 3 had cerebral infarction, and 3 had the onset of paraplegia or paraparesis. Primary endoleaks were observed in 10 patients (11%). During the mean follow-up period of 43 +/- 29 months, 10 patients had endoleaks and 8 had stent-graft migration. The aneurysm-related mortality rate was 12%. Our early outcomes of elective and emergency thoracic endovascular aortic repair with homemade stent-grafts demonstrated their therapeutic effectiveness in high-risk patients with various thoracic diseases. Endoleaks and migration were, however, the factors most responsible for secondary intervention in the mid-term period. Careful follow-up of the treated patients is needed to avoid the major complication in the long-term period.
authors.affiliation: Department of Surgery, Kurume University School of Medicine, Kurume, Japan.
authors.forename: Atsuhisa
authors.initials: A
authors.lastname: Tanaka
authors.forename: Seiji
authors.initials: S
authors.lastname: Onitsuka
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Shintani
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Ohno
authors.forename: Shinichi
authors.initials: S
authors.lastname: Nata
authors.forename: Kurando
authors.initials: K
authors.lastname: Kanaya
authors.forename: Shuji
authors.initials: S
authors.lastname: Fukunaga
authors.forename: Shinichi
authors.initials: S
authors.lastname: Hiromatsu
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Akashi
authors.forename: Shigeaki
authors.initials: S
authors.lastname: Aoyagi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic; D001018:Aortic Diseases / Q000601:surgery / Q000628:therapy; D057510:Endovascular Procedures; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D058017:Vascular Grafting