Thoracic aortic aneurysm repair with endovascular stent-grafts

Charles P. Semba, R. Scott Mitchell, D. Craig Miller, Noriyuki Kato, Stephen T. Kee, Jason T. Chen, Michael D. Dake

Research output: Contribution to journalArticle

39 Scopus citations

Abstract

The purpose of the study was to describe the clinical experience in using endoluminal stent-grafts for the treatment of thoracic aortic aneurysms in high-risk patients. Patients with aneurysms of the descending thoracic aorta who were considered high surgical risks underwent evaluation for endoluminal repair. The prosthesis was constructed from Z stents covered with polyester fabric using dimensions based upon preprocedural computed tomography scans and angiography. Through a femoral arteriotomy or left retroperitoneal flank incision, a 22-24 Fr delivery catheter was inserted and advanced through the aorta to the target site under fluoroscopic guidance in the operating suite. The stent-graft prosthesis was deployed at the site of the aneurysm. 44 patients (36 male, 8 female; mean age 36 years) underwent stent-graft repair for thoracic aneurysms (mean diameter 6.3 cm). The deployment was technically successful in all cases, with complete aneurysm thrombosis in 88%. The 30-day perioperative mortality rate was 6.8% and 35- month actuarial survival was 82%. There were no cases of stent migration, surgical conversion or intraprocedural death. Paraplegia occurred in two patients who underwent simultaneous surgical infrarenal aortic aneurysm repair immediately followed by stent-graft placement for a coexisting thoracic aneurysm. The conclusion was that placement of endoluminal stent- grafts for repair of thoracic aortic aneurysms is technically feasible in high-risk patients in whom conventional surgery is contraindicated. Long- term studies are needed to determine protection against aneurysm rupture and patient survival.

Original languageEnglish (US)
Pages (from-to)98-103
Number of pages6
JournalVascular Medicine
Volume2
Issue number2
DOIs
StatePublished - Jan 1 1997
Externally publishedYes

Keywords

  • Aneurysm
  • Arteries
  • Grafts and prostheses
  • Interventional procedures
  • Therapy
  • Thoracic

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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  • Cite this

    Semba, C. P., Mitchell, R. S., Miller, D. C., Kato, N., Kee, S. T., Chen, J. T., & Dake, M. D. (1997). Thoracic aortic aneurysm repair with endovascular stent-grafts. Vascular Medicine, 2(2), 98-103. https://doi.org/10.1177/1358863X9700200205