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Stent graft treatment of thoracic aortic disease

Alessandro S Bortone1, Emanuela De Cillis, Donato D'Agostino

  • 1Interventional Cardiology, Institute of Cardiac Surgery, Department of Emergency and Organ Transplantation, University of Bari School of Medicine, Bari, Italy.

Surgical Technology International
|September 30, 2004
PubMed

Insights

Endovascular repair of thoracic aortic disease shows promising long-term outcomes and efficacy. This minimally invasive approach offers a valid alternative to medical management, particularly for complex aortic conditions.

Area of Science:

  • Cardiovascular Surgery
  • Vascular Surgery
  • Interventional Radiology

Background:

  • Thoracic aortic diseases encompass aneurysms, dissections, and traumatic injuries, posing significant clinical challenges.
  • Traditional open surgical repair carries substantial risks, driving the need for less invasive alternatives.
  • Endovascular management has emerged as a promising therapeutic strategy for these complex conditions.

Purpose of the Study:

  • To evaluate the efficacy and long-term outcomes of endovascular management for various thoracic aortic diseases.
  • To compare the outcomes of endovascular treatment with medical management for chronic type B dissections.
  • To assess the safety and complication rates associated with endovascular stent-graft repair.

Main Methods:

  • Retrospective analysis of 129 patients treated between March 1999 and August 2003.
  • Patients were categorized into groups based on diagnosis: aneurysms, post-traumatic lesions, and type B dissections.
  • Preoperative assessment included computed tomography (CT) scans and angiography; stent-graft deployment was guided by transesophageal echocardiography (TEE).

Main Results:

  • Optimal stent-graft deployment was achieved in 95.3% of treated patients.
  • The overall operative mortality rate was 3.7% (4 hospital deaths).
  • During a mean follow-up of 20.8 months, the mortality rate in the endovascular group was 6.5%, significantly lower than the 31.8% in the medically managed group (p<0.001).

Conclusions:

  • Endovascular management is an effective and safe treatment option for thoracic aortic diseases, including acute presentations.
  • The procedure demonstrates favorable long-term outcomes and a reduced mortality rate compared to medical therapy.
  • No spinal cord injuries or stent-graft-related complications were observed in this cohort.

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