Endovascular treatment of thoracic aortic disease: four years of experience
Alessandro S Bortone1, Emanuela De Cillis, Donato D'Agostino
1Dipartimento Emergenza e Trapianti d'Organo, Sezione di Cardiochirurgia, Piazza Giulio Cesare 11 70124 Bari, Italy. abortone@cardiochir.uniba.it
Circulation
|September 15, 2004
Summary
Stent graft treatment for descending thoracic aorta diseases shows promising mid-term efficacy and low mortality. This endovascular approach is a viable option, even for acute conditions, with ongoing long-term follow-up.
Area of Science:
- Cardiovascular Surgery
- Endovascular Interventions
- Thoracic Aortic Disease
Background:
- Descending thoracic aorta diseases pose significant clinical challenges.
- Stent graft treatment offers a minimally invasive therapeutic option.
- Evaluating the efficacy and outcomes of stent graft interventions is crucial.
Purpose of the Study:
- To investigate the efficacy and middle-term results of stent graft treatment for descending thoracic aorta diseases.
- To assess the outcomes in patients with aneurysms, post-traumatic lesions, and complicated type B dissections.
- To compare outcomes with medical management for specific chronic dissection cases.
Main Methods:
- Retrospective study of 132 patients (March 1999 - October 2003).
- Patients categorized into aneurysms, post-traumatic lesions, complicated type B dissections, and medical management groups.
- Preoperative assessment included computed tomography (CT) scan and angiography.
- Follow-up involved serial chest CT scans for 100% completeness.
Main Results:
- Optimal stent graft deployment achieved in 96.4% of treated patients.
- Low operative mortality of 3.9% (4 hospital deaths).
- No spinal cord injuries observed; low incidence of stent graft complications.
- Medical management group showed a significantly higher mortality of 40.9%.
Conclusions:
- Endovascular stent graft treatment is a valid option for thoracic aortic diseases, including acute cases.
- The treatment demonstrates proven efficacy in the middle-term.
- Further long-term follow-up is necessary to fully ascertain durability and late outcomes.
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