title: Endovascular versus open treatment of degenerative aneurysms of the descending thoracic aorta: a single center experience.
abstract: Multiple reports could show a reduced risk for thoracic endovascular aortic repair (TEVAR) compared with open treatment. The aim of this study was to evaluate our twelve-year TEVAR experience for thoracic aortic aneurysms and compare these results with open repair. All patients who had received either open or endovascular surgery for a degenerative aortic aneurysm of the descending thoracic aorta in our center were evaluated retrospectively. N = 53 TEVAR patients (1997-2008) were included and their course was compared with an open-surgery group of n = 24 patients (1992-2002). The percentage of symptomatic patients was 43% (TEVAR) and 42% (open surgery). Endovascular treatment resulted in a significantly reduced 30-day (5.7% versus 25% P = 0.02) and one-year mortality (19% versus 42% P = 0.05) in the entire cohort. Symptomatic patients benefited the most from TEVAR (30-day mortality: 9% versus 40%, P = 0.06; one-year mortality: 27% versus 70%, P = 0.049) whereas the survival of our asymptomatic patients was not significantly different (30-day mortality: 3% versus 14%, P = 0.22; one-year mortality: 13% versus 21%, P = 0.65). Lastly, Kaplan-Meier analysis showed a significantly improved survival after TEVAR (P = 0.05) and in particular for the symptomatic patients (P = 0.003). In conclusion, endovascular treatment for patients with degenerative thoracic aortic aneurysms has significant advantages over open surgery.
authors.affiliation: Department of Surgery, University Hospital Grosshadern, Ludwig-Maximilian's-University, Munich, Germany. joachim.andrassy@med.uni-muenchen.de
authors.forename: Joachim
authors.initials: J
authors.lastname: Andrassy
authors.forename: Rolf
authors.initials: R
authors.lastname: Weidenhagen
authors.forename: Georgios
authors.initials: G
authors.lastname: Meimarakis
authors.forename: M
authors.initials: M
authors.lastname: Rentsch
authors.forename: K-W
authors.initials: KW
authors.lastname: Jauch
authors.forename: Reinhard
authors.initials: R
authors.lastname: Kopp
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017545:Aortic Aneurysm, Thoracic / Q000401:mortality / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D057510:Endovascular Procedures / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D015607:Stents; D016896:Treatment Outcome; D058017:Vascular Grafting / Q000009:adverse effects