Midterm outcome in 158 consecutive Gore TAG thoracic endoprostheses: single center experience

Area of Science:

• Cardiovascular Surgery
• Endovascular Interventions
• Thoracic Aortic Disease

Background:

• Open surgical repair of descending thoracic aortic pathologies is limited in high-risk patients due to comorbidities and anatomy.
• Endoluminal grafting presents a less invasive alternative for select patient populations.
• The Gore TAG thoracic endoprosthesis was evaluated for treating diverse descending thoracic aortic pathologies.

Purpose of the Study:

• To assess the feasibility and safety of the Gore TAG endoprosthesis for endovascular repair.
• To evaluate outcomes in high surgical risk patients with various descending thoracic aortic pathologies.
• To review clinical experience with endoluminal grafting in a challenging patient cohort.

Main Methods:

• A consecutive series of 158 high surgical risk patients underwent attempted Gore TAG endoprosthesis delivery.
• Indications included atherosclerotic aneurysm, aortic dissection, penetrating aortic ulcer, and others.
• Data were collected on device delivery, complications, and mortality between February 2000 and July 2004.

Main Results:

• Successful device delivery was achieved in 98.7% of patients.
• Complications included transient paraparesis (1.9%) and paraplegia (0.6%).
• Thirty-day mortality was 3.8%, with an overall mortality of 17.3% at a mean follow-up of 21.5 months.

Conclusions:

• Endoluminal grafting with the Gore TAG endoprosthesis is feasible and safe for descending thoracic aortic pathologies in high-risk patients.
• This approach provides a viable alternative for patients unsuitable for open repair.
• Further studies and long-term follow-up are recommended to confirm durability and safety.