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Thoracic aortic stent grafts--early experience from two centres using commercially available devices
P R Taylor1, P A Gaines, C L McGuinness
1Department of Surgery, Guy's Hospital, London, SE1 9RT, U.K.
Summary
Thoracic stent grafts provide a safe alternative to open surgery for aortic aneurysms, demonstrating low morbidity and mortality. Further long-term studies are needed to confirm the durability of these endovascular repairs.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Interventional Cardiology
Background:
- Open surgical repair of thoracic aortic aneurysms carries significant risks.
- Endovascular stent grafts present a less invasive treatment option.
Purpose of the Study:
- To evaluate the morbidity and mortality associated with endovascular stent graft treatment for distal arch and descending thoracic aortic aneurysms.
Main Methods:
- A prospective observational study included 37 consecutive patients treated between July 1997 and October 2000.
- Indications for treatment varied, including degenerative aneurysms, dissections, and traumatic injuries.
- Procedures were performed electively in 19 patients and non-electively in 18.
Main Results:
- In-hospital and 30-day mortality was 8% (3 non-elective deaths); no elective patients died.
- Complications included one stroke, endoleaks requiring further intervention, and one late death from aortic rupture.
- No patients experienced paraplegia or renal failure.
Conclusions:
- Thoracic stent grafts can be performed with acceptable morbidity and mortality rates.
- Endovascular repair offers a viable alternative to open surgery for these complex aortic pathologies.
- Long-term follow-up is essential to determine the durability of thoracic stent grafts.