[Endovascular repair of descending aortic pseudoaneurysms].
OBJECTIVE
To evaluated the feasibility, efficacy, and outcome of endovascular repair for descending aortic pseudoaneurysms.


METHODS
From April 2007 to November 2010, 20 patients of descending aortic pseudoaneurysm were treated. There were 18 male and 2 female, aged from 28 to 82 years with a mean of (58 ± 16) years. In this group, 4 patients were diagnosed as Behçet's syndrome, 6 patients as mycotic pseudoaneurysms with positive blood culture, 6 patients as suspected mycotic pseudoaneurysms, 1 patient with iatrogenic pseudoaneurysm and 1 patient with chronic grain-mononuclear cell leukemia, the other 3 patients with unknown reasons. The 88.5% of aortic pseudoaneurysms were located at abdominal aorta. Fifteen patients underwent endovascular therapy and 2 patients were treated by traditional open surgery. The other 3 patients underwent conservative treatments. The data of treatments and follow-up in the 15 patients who received endovascular repairs were retrospectively analyzed.


RESULTS
Endovascular therapy was performed successfully on the 15 patients, and the technique successful rate was 15/15. Total 15 stents were transluminal placed including 6 bifurcate stent-grafts, 6 abdominal straight stent-grafts, 2 thoracic straight stent-grafts and 1 abdominal bare stent. One patient was treated by stent assisted embolization. Perioperative mortality rate was 0. Only 2 primary type IV endoleaks were found. Fourteen patients were successfully followed up. During a mean follow-up of 538 days, 8 (57.1%) patients were uneventful. Six (42.9%) patients were complicated by aneurysm related events, including 4 (28.6%) aneurysm-related deaths, 1 (7.14%) with delayed endoleak and 1 (7.14%) with recurrent pseudoaneurysm which was retreated by another stent-graft.


CONCLUSIONS
Endovascular therapy for descending aortic pseudoaneurysms is a feasible and mini-invasive option with high technique success rate and low perioperative mortality rate. However, risk of recurrence and rupture to death of pseudoaneurysm remains high during follow-up. Treating the underlying reasons and intensively follow-up may be good for improving the prognosis of descending aortic pseudoaneurysms treated by endovascular therapy.
Department of Vascular Surgery, Peking Union Medical College Hospital, Beijing 100730, China.
Yue-xin
YX
Chen
Chang-wei
CW
Liu
Yong-jun
YJ
Li
Yue-hong
YH
Zheng
Wei
W
Ye
Bao
B
Liu
Jiang
J
Shao
Rong
R
Zeng
Wei-wei
WW
Wu
Xiao-jun
XJ
Song
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017541:Aneurysm, False / Q000601:surgery*; D001013:Aorta, Thoracic; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents