Endovascular treatment of thoracic aortic disease: Mid-term follow-up

Maurizio Tespili, Carlo Banfi, Orazio Valsecchi, Luigi Aiazzi, Cristina Ricucci, Giulio Guagliumi, Giuseppe Musumeci, Paolo Ferrazzi, Michael D. Dake

Research output: Contribution to journalArticlepeer-review

27 Scopus citations

Abstract

Objective: The aim of this study was to evaluate the mid-term follow-up in a cohort of patients with acute or chronic descending aortic disease treated by stent-graft repair. Background: Since 1999, endovascular stent-graft placement has been reported as an alternative treatment to surgical approach for a variety of thoracic aortic diseases; however, results beyond initial short-term follow-up are not widely available for the broad range of applications. Methods: From March 2001, 43 consecutive patients with traumatic aortic transection (group A = 16) and complicated type B aortic dissection or aneurysm (group B = 27) underwent stent-graft implantation. All patients underwent computed tomography (CT) scan as preoperative assessment and in 26 a transesophageal echo (TEE) exam was performed. Results: Technically successful stent-graft deployment was achieved in all patients. No patient required surgical conversion and no cases of paraplegia occurred. The overall in-hospital mortality was 9.3%. A residual endoleak (type II) was detected in one group B patient who was managed conservatively. The mean follow-up was 29 ± 8 months (range 10-48 months). No patient died during late follow-up after hospital discharge. At 12 months, one patient (2.5%) who had stent graft repair of an aortic dissection developed an asymptomatic type I endoleak. Three asymptomatic patients with chronic dissection had a persistent retrograde perfusion of the thoracic false lumen via a distal tear(s) in the dissection septum. Conclusion: Our results of stent-graft treatment of complicated and uncomplicated diseases of the descending aorta confirms that this alternative to open repair is a safe, less invasive, and relatively low risk approach. Medium-term follow-up results suggest that it is effective and durable therapy with low associated mortality and morbidity rates.

Original languageEnglish (US)
Pages (from-to)595-601
Number of pages7
JournalCatheterization and Cardiovascular Interventions
Volume70
Issue number4
DOIs
StatePublished - Oct 1 2007
Externally publishedYes

Keywords

  • Aneurysm
  • Aortic dissection
  • Endoprosthesis
  • Endovascular
  • Thoracic aortic disease
  • Traumatic aortic rupture

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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