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Device-specific outcomes with endografts for thoracic aortic aneurysms
1Division of Vascular Surgery, Medical Centre, University of Cologne, Cologne, Germany.
The Journal of Cardiovascular Surgery
|March 29, 2005
Summary
Endovascular stent grafting is technically feasible for various thoracic aortic pathologies. However, mid-term and long-term outcomes, and the impact of different stent grafts, require further investigation.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Medical Device Technology
Background:
- Endovascular therapy for abdominal aortic aneurysms is well-documented.
- Limited data exists on thoracic aortic aneurysms, specifically concerning stent graft influence on outcomes.
Purpose of the Study:
- To investigate the influence of different stent graft types on thoracic aortic aneurysm sac behavior and perioperative outcomes.
- To analyze the current literature on endovascular treatment of thoracic aortic pathologies.
Main Methods:
- Systematic MEDLINE search from 1990-2004 for thoracic aortic aneurysms, descending aorta, and stent grafts.
- Analysis of 152 relevant papers from 48 centers, encompassing over 3,000 patients.
- Data extraction on technical success, mortality, and paraplegia rates.
Main Results:
- Technical success rates ranged from 76% to 100% across diverse thoracic aortic pathologies.
- Pooled procedural and in-hospital mortality was 6.8%; paraplegia rate was 1.7%.
- Significant heterogeneity among studies precluded direct comparisons.
Conclusions:
- Endoluminal stent grafting is technically feasible for a wide array of thoracic aortic conditions.
- Short-term results are promising, but mid- and long-term data are scarce.
- The impact of various stent graft types on outcomes remains unanswered.