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Online ISSN 1827-1847
Piffaretti G. 1, Tozzi M. 1, Lomazzi C. 1, Rivolta N. 1, Caronno R. 1, Bacuzzi A. 2, Cuffari S. 2, Castelli P. 1
1 Unit of Vascular Surgery, Department of Surgery University of Insubria, Varese, Italy
2 Unit of Anaesthesia and Palliative Care University of Insubria, Varese, Italy
Aim. A retrospective and comparative analysis was performed to evaluate the complication rate and early survival of all patients treated for descending thoracic aortic aneurysms by either conventional surgery or stent-grafting.
Methods. Seventeen patients had endovascular repair for descending thoracic aortic aneurysm. A historic non-randomized cohort of 11 patients who previously underwent open repair, and who would have been candidate for endoluminal repair as comparative group. Demographic data and risk factors were well-matched.
Results. Stent-graft deployment was successful in all patients. Operative time, median blood loss, intensive care unit and hospital stays, were all in favour of endovascular repair (P < 0.05). Major and minor morbidities, and also 30-day mortality were lower in the endovascular group but did not reach statistical significance. Survival rates at 3 and 5 years were 90% for stent-graft group, whereas for conventional surgery group 80% and 70%, respectively.
Conclusion. Stent-graft treatment for descending thoracic aortic aneurysms is feasible: early survival and complications rates were similar for both the open and endovascular techniques. Conventional replacement of the descending thoracic aorta still presents a significant technical challenge, and one of the most stressing intervention for the cardiovascular, respiratory, and visceral functions of the patient.