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THE JOURNAL OF CARDIOVASCULAR SURGERY

A Journal on Cardiac, Vascular and Thoracic Surgery


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III. MANAGEMENT OF THE “POLYVASCULAR PATIENT”
3. THORACIC ANEURYSMS  THE MULTIFOCAL ATHEROSCLEROTIC PATIENT
DIAGNOSIS AND MANAGEMENT IN 2003


The Journal of Cardiovascular Surgery 2003 June;44(3):465-70

language: English

Current indication for endovascular treatment of thoracic aneurysms

Brunkwall J. 1, Gawenda M. 1, Südkamp M. 2, Zähringer M. 3

1 Unit of Vascular Surgery University Clinics University of Cologne, Cologne, Germany
2 Department of Cardiovascular ­and Thoracic Surgery University Clinics University of Cologne, Cologne, Germany
3 Department of Radiology University Clinics University of Cologne, Cologne, Germany


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The mor­bid­ity ­and mor­tal­ity ­for ­open treat­ment of tho­rac­ic aor­tic aneu­rysms ­have ­declined ­over ­the ­years, ­but it is ­still a ­major clin­i­cal prob­lem. The rea­son ­for ­the mor­tal­ity is in ­almost 50% of ­the cas­es car­diac fail­ure. Endoluminal treat­ment of abdom­i­nal aor­tic aneu­rysm is wide­ly dis­trib­ut­ed ­and ­with prom­is­ing ­results, ­although ­not as ­free ­from com­pli­ca­tions as expect­ed 10 ­years ­ago. This tech­nique ­has ­also ­been adopt­ed ­for ­the tho­rac­ic aor­tic aneu­rysm as ­the trau­ma is ­much ­less ­than in ­open sur­gery. In ­our ­own per­son­al ­series no spe­cif­ic work­up ­for cor­o­nary ­heart dis­ease ­has ­been ­made ­and ­the mor­tal­ity of stent­graft­ing of ­the tho­rac­ic aor­ta ­was 2.4%. A sur­vey of ­the ­world lit­er­a­ture, includ­ing elec­tive ­and ­acute dis­sec­tions ­and aneu­rysms ­revealed 642 ­patients treat­ed ­with stent­graft ­with a mor­tal­ity of 6.2%, ­although no car­di­o­log­ic ­work up ­had ­been per­formed. These num­bers com­pete ­well ­with ­those of ­open sur­gery, ­but a system­at­ic pros­pec­tive com­par­i­son ­would be need­ed in ­order to ­state ­the ­real mor­tal­ity in ­both ­groups.

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