title: Results after thoracic endovascular aortic repair in penetrating atherosclerotic ulcers.
abstract: BACKGROUND
  Results after thoracic endovascular aortic repair in penetrating atherosclerotic ulcers are uncertain.
  
  
  METHODS
  From 1997 to 2010, 72 patients (median age, 67 years) presented with penetrating atherosclerotic ulcers (symptomatic, 58%; rupture, 36%). Median logistic EuroSCORE (European System for Cardiac Operative Risk Evaluation) was 32. Mean follow-up was 42 months (range, 19 to 56 months). In-hospital mortality, occurrence of endoleaks, reinterventions, and survival were recorded.
  
  
  RESULTS
  In hospital mortality was 4%. The primary success rate was 100%. Actuarial survival rates at 1, 5, and 10 years were 93%, 72%, and 60%. The early type I and III endoleak rate was 2.7%. The late type I and III endoleak rate was 4%. One late surgical conversion was performed. Aortic-related actuarial survival was 100% at 1 year and 98.6% at 5 and 10 years. Age older than 75 years (odds ratio, 8.928; 95% confidence interval, 2.05 to 38.93) was an independent predictor of survival. During follow-up, 21% of patients underwent a cardiovascular intervention.
  
  
  CONCLUSIONS
  Results after thoracic endovascular aortic repair in patients with penetrating atherosclerotic ulcers are excellent for early and late type I and III endoleak formation and aortic-related survival. Patients are mainly limited by age and by the aggressive underlying obliterative atherosclerotic process.
authors.affiliation: Department of Cardiovascular Surgery, University Hospital Berne, Berne, Switzerland. martin.czerny@insel.ch
authors.forename: Martin
authors.initials: M
authors.lastname: Czerny
authors.forename: Martin
authors.initials: M
authors.lastname: Funovics
authors.forename: Gottfried
authors.initials: G
authors.lastname: Sodeck
authors.forename: Julia
authors.initials: J
authors.lastname: Dumfarth
authors.forename: Maria
authors.initials: M
authors.lastname: Schoder
authors.forename: Andrzej
authors.initials: A
authors.lastname: Juraszek
authors.forename: Tomasz
authors.initials: T
authors.lastname: Dziodzio
authors.forename: Christian
authors.initials: C
authors.lastname: Loewe
authors.forename: David
authors.initials: D
authors.lastname: Reineke
authors.forename: Eva
authors.initials: E
authors.lastname: Krähenbühl
authors.forename: Michael
authors.initials: M
authors.lastname: Grimm
authors.forename: Marek
authors.initials: M
authors.lastname: Ehrlich
mesh_terms: D000367:Age Factors; D000368:Aged; D001013:Aorta, Thoracic / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D001018:Aortic Diseases / Q000601:surgery*; D001019:Aortic Rupture / Q000601:surgery*; D050197:Atherosclerosis / Q000601:surgery*; D057867:Endoleak / Q000209:etiology / Q000401:mortality / Q000601:surgery; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality / Q000601:surgery; D016016:Proportional Hazards Models; D012086:Reoperation; D012307:Risk Factors; D016019:Survival Analysis