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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
Rivista di Chirurgia Vascolare ed Endovascolare
Italian Journal of Vascular and Endovascular Surgery 2007 Dicembre;14(4):279-85
Endovascular repair versus conventional surgery for descending thoracic aortic aneurysms
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.