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Editor's Choice - Ten-year Experience with Endovascular Repair of Thoracoabdominal Aortic Aneurysms: Results from 166

E L G Verhoeven1, A Katsargyris1, F Bekkema2

  • 1Department of Vascular and Endovascular Surgery, Paracelsus Medical University, Nürnberg, Germany.

European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
|January 21, 2015
PubMed

Insights

Endovascular repair of thoracoabdominal aortic aneurysms (TAAA) using fenestrated and branched stent grafts is safe and effective for high-risk patients. While reintervention rates are notable, mid-term outcomes demonstrate good survival and vessel patency.

Area of Science:

  • Vascular Surgery
  • Endovascular Repair
  • Thoracoabdominal Aortic Aneurysm (TAAA)

Background:

  • Thoracoabdominal aortic aneurysms (TAAA) pose significant surgical challenges.
  • Traditional open repair carries high morbidity and mortality, leading to patient selection difficulties.
  • Endovascular techniques offer a less invasive alternative for complex aortic pathologies.

Purpose of the Study:

  • To evaluate the 10-year experience with endovascular TAAA repair.
  • To assess the safety and efficacy of fenestrated and branched stent grafts in TAAA treatment.
  • To analyze outcomes including mortality, complications, reintervention rates, and long-term survival.

Main Methods:

  • A consecutive series of 166 patients undergoing endovascular TAAA repair between January 2004 and December 2013.
  • Prospective data collection on patient demographics, aneurysm characteristics, and procedural details.
  • Analysis of technical success, peri-operative mortality, spinal cord ischemia (SCI), and long-term follow-up.

Main Results:

  • Technical success rate of 95% in 166 patients (mean age 68.8 years).
  • 30-day operative mortality was 7.8%, with 9% in-hospital mortality.
  • Peri-operative spinal cord ischemia (SCI) occurred in 9% of patients (1.2% permanent paraplegia). Mid-term survival and target vessel patency rates were favorable, though a 24% reintervention rate was observed.

Conclusions:

  • Endovascular repair of TAAA using fenestrated and branched stent grafts is a safe and effective mid-term option for high-risk patients in high-volume centers.
  • The procedure demonstrates acceptable mortality and complication rates.
  • A significant rate of reintervention is necessary and should be anticipated in the management of TAAA patients treated with this technique.
Abstract

Keywords:
Aortic aneurysmBranchedEndovascular repairFenestratedThoracoabdominal

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