Open surgery or stent repair for descending aortic diseases: Results and risk factor analysis

Less invasive stent graft (SG) repair was compared with open surgery for patients with descending thoracic aortic diseases.

Thirty six patients undergoing SG repair (SG group) were matched for age, sex, location and pathology of aortic disease with a 36-patient surgical cohort (OS group), and retrospective matched case-control study was performed with respect to outcomes and risk factors for adverse outcomes.

Mortality rate was 5.6% in OS group and none in SG group (p=0.4930), and there was no significant difference in stroke and paraplegia rates between two groups. A higher prevalence of secondary procedures due to endoleak was seen in the patients of SG group (p=0.0113). Perioperative hypotension was an independent risk factor for in-hospital mortality (p=0.0071, odds ratio=34) and preoperative renal dysfunction was independent risk factor for paraplegia (p=0.0076, odds ratio=17.6).

Although the importance of patient selection is emphasized to prevent endoleak, mortality rate was low in patients who underwent SG repair. SG repair is a promising alternative technique to open surgery for thoracic aortic diseases.