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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
Rivista di Chirurgia Vascolare ed Endovascolare
Italian Journal of Vascular and Endovascular Surgery 2008 Giugno;15(2):87-93
Early and midterm results after endovascular treatment of atherosclerotic descending thoracic aortic aneurysms: a single-centre experience
Speziale F. 1, Sbarigia E. 1, Ruggiero M. 1, Capoccia L. 1, Marino M. 1, Salvatori F. M. 2, Fanelli F. 2
1 Department of Vascular Surgery General Surgery Department for surgery and organ transplantation “Paride Stefanini” Polyclinic Hospital Umberto I University of Rome “La Sapienza”, Rome, Italy
2 Interventional Radiology Unit, Radiology Department Polyclinic Hospital Umberto I University of Rome “La Sapienza”, Rome, Italy
Aim. Despite significant improvement in anesthetic, surgical techniques and postoperative care, the mortality and morbidity rate in thoracic aortic aneurysms (TAA) open repair remains high. Endovascular stent-graft repair may provide an alternative treatment in these patients. The aim of this retrospective study was to evaluate short and mid-term morbidity and mortality rate after endovascular stent-graft treatment of degenerative non dissecting TAA.
Methods. Between June 2000 and December 2005, 22 consecutive patients with degenerative TAAs, underwent endovascular stent-graft treatment in elective procedure. Follow-up investigations were performed after 1, 3, 6 months and annually thereafter.
Results. Perioperative mortality rate was 4.5% (1/22). Primary technical success, defined as successful deployment and exclusion of the lesion without evidence of type I or III endoleak, was achieved in 20 (91%) patients. One perioperative type-I and two perioperative type-II endoleaks were observed. No ischemic complications (paraplegia, visceral or peripheral ischaemia) or open surgical conversion were recorded. In one patient an 18-month computed tomography-scan showed dilatation of distal thoracic aorta below the graft. Mean follow-up was 34 months (range 5-66 months).
Conclusion. Elective endovascular therapy of degenerative thoracic aortic aneurysms seems to be a feasible procedure allowing good results and a low incidence of complications in a mid-term follow up.