title: Pathology-specific late outcome after endovascular repair of thoracic aorta: a single-centre experience.
abstract: OBJECTIVE
  Endovascular treatment of thoracic aortic lesions appears to be advantageous. However, long-term outcomes remain poorly reported. This retrospective study reported 6-year outcomes of thoracic endovascular aortic repair.
  
  
  METHODS
  A total of 74 patients underwent endovascular thoracic aorta treatments between 1999 and 2007; 13 had thoracic aortic dissections, 19 had traumatic aortic injuries, 35 had aneurysms, 6 had pseudoaneurysms and 1 had a penetrating ulcer. The mean follow-up was 66 months after 30 perioperative days. Yearly follow-ups included computed tomography angiography or magnetic resonance angiography. Patient demographics, mortality, complications and reinterventions were analysed.
  
  
  RESULTS
  The early 30-day mortality and the overall late mortality were 9.5 (7/74) and 37.8% (28/74), respectively. Late mortality was higher in patients with aneurysms than in the other groups (20/35; 57% vs 8/39; 20.5%; P = 0.002). Aortic-related mortality occurred in 5/35 (14%) patients with aneurysms, but not in other groups (P = 0.02). No relationships among late complications were found for traumatic aortic injuries. The most common complication was an endoleak (21/74, 28.4%), which occurred more frequently with aneurysms than other disorders (18/35, 51.4% vs 3/39, 7.7%; P < 0.001). Endoleaks also occurred most frequently in aortic-related deaths (16/69 vs 5/5; P = 0.001). Type 1 endoleaks occurred significantly more often with aneurysms (13/35) than with other disorders (P = 0.004). Reintervention was required in 9 patients (12%); 8 with atherosclerotic aneurysms (8/35; 23%). A false lumen was thrombosed in 54% of dissections (7/13), and shrank in 39% (5/13).
  
  
  CONCLUSIONS
  Long-term outcomes depended on aortic pathology. Aortic aneurysms were the most complicated and caused the highest mortality, probably due to atherosclerotic disease evolution. Patients with traumatic aortic injuries appeared to have the best long-term outcomes.
authors.affiliation: Department of Interventional Radiology and Cardio-vascular and Thoracic Diagnostic Imaging, Louis Pradel University Hospital, Bron, France clemence.dufour01@chu-lyon.fr.
authors.forename: Clémence
authors.initials: C
authors.lastname: Dufour
authors.affiliation: Department of Interventional Radiology and Cardio-vascular and Thoracic Diagnostic Imaging, Louis Pradel University Hospital, Bron, France.
authors.forename: Delphine
authors.initials: D
authors.lastname: Gamondes
authors.affiliation: Department of Interventional Radiology and Cardio-vascular and Thoracic Diagnostic Imaging, Louis Pradel University Hospital, Bron, France.
authors.forename: Adeline
authors.initials: A
authors.lastname: Mansuy
authors.affiliation: Department of Cardio-vascular Surgery, Louis Pradel University Hospital, Bron, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Robin
authors.affiliation: Department of Interventional Radiology and Cardio-vascular and Thoracic Diagnostic Imaging, Louis Pradel University Hospital, Bron, France.
authors.forename: Loïc
authors.initials: L
authors.lastname: Boussel
authors.affiliation: Department of Interventional Radiology and Cardio-vascular and Thoracic Diagnostic Imaging, Louis Pradel University Hospital, Bron, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Douek
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000401:mortality / Q000601:surgery; D017541:Aneurysm, False / Q000401:mortality / Q000601:surgery; D001013:Aorta, Thoracic / Q000293:injuries / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000401:mortality / Q000601:surgery; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D057510:Endovascular Procedures / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Endoleak; Endovascular repair; Thoracic aorta