Endovascular treatment of descending thoracic aortic disease. A single center experience

Aim of the study was to assess if endovascular treatment is a feasible alternative in patients with descending thoracic aortic disease.

Seventy-three patients were admitted for stent-grafting of descending thoracic aortic disease during the period 1997-2008. The majority of the patients had aneurysm (35) or type B dissection (21), but also traumas, penetrating ulcers and other conditions were treated. Sixteen (22%) were unfit for open surgery. Thirty-four (47%) of the patients were symptomatic and 18 had rupture. The primary technical success rate was 96%.

Early mortality (<30 days) for the whole group was 3%. Early endoleak (<30 days) was identified in 11 patients (15%) of whom 4 (5%) had a secondary procedure. In addition, two trauma patients required insertion of a new stent-graft due to stent-graft collapse. Two patients had stroke, one had paraplegia and two paraparesis. Mean follow-up was 3.1 years (range 0-12 years). Late endoleak (>30 days) was identified in 5 patients (7%) treated by 6 secondary procedures. One patient (1.7%) had an explant. Two patients have had extensions of endografts due to increasing diameter of the aorta at the distal end of the stent-graft.

Endovascular treatment seems to be a viable alternative in patients with descending thoracic aortic disease.