Transfemoral intraluminal stent graft implanted for thoracic aortic aneurysm

We describe two patients with inoperable descending thoracic aortic aneurysm. The first patient had complained of severe back pain for at least thirteen years. Radiological examination revealed a large posterior mediastinal mass that was misdiagnosed in 1981. Follow-up studies in 1992 revealed this mass to be a large descending thoracic aortic aneurysm, eroding the vertebral bodies of T3 through T6 and entering the spinal canal. Because of the high risk, thoracic aortic surgery was not performed. The second patient had an acute descending thoracic aortic aneurysm. There was contraindication to a second surgical approach due to previous thoracotomy. Both patients underwent an intraluminal bypass of the descending thoracic aorta with a stent graft. Postplacement aortogram and follow-up studies showed that aneurysm was effectively excluded. We believe that this type of therapy should be offered to selected individuals who are considered by cardiovascular surgeons to be a high risk for thoracic aneurysm surgery.