Endovascular stent-graft treatment for diseases of the descending thoracic aorta
| Autor: | G. Ferlan, Giovanni Dialetto, Stefano Schena, Vito Michele Paradiso, L de Luca Tupputi Schinosa, G. Mannatrizio, Alessandro Santo Bortone, Maurizio Cotrufo |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male Reoperation medicine.medical_specialty Adolescent medicine.medical_treatment Aorta Thoracic Aortic aneurysm Pseudoaneurysm Blood Vessel Prosthesis Implantation Aneurysm Postoperative Complications medicine.artery Medicine Thoracic aorta Humans Aged Aortic dissection Aorta Aortic Aneurysm Thoracic business.industry Stent General Medicine Middle Aged medicine.disease Surgery Aortic Dissection surgical procedures operative Descending aorta Female Stents Radiology Cardiology and Cardiovascular Medicine business Tomography X-Ray Computed Aneurysm False |
| Zdroj: | European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. 20(3) |
| ISSN: | 1010-7940 |
| Popis: | Objective: Assessment of endovascular stent-graft treatment for diseases of the descending thoracic aorta as a valid and effective alternative to surgery. Methods: From March 1999 to August 2000, a total of 16 patients underwent deployment of endovascular stentgrafts in the descending thoracic aorta. Patients were divided into three groups according to the type of lesion. Group AOna 8U included five patients with atherosclerotic aneurysm and three with chronic post-traumatic pseudoaneurysm. Patients with acute post-traumatic pseudoaneurysmOna 3U and type B aortic dissectionOna 5U were included in Groups B and C, respectively. All patients underwent 5-mm chest spiral angio-computerized tomography (CT) scan and angiography as preoperative assessment. The deployed stent-graft systems were Talente-Medtronic and Excluder w -Gore. Results: A total of 20 stent-grafts were placed. Two patients required deployment of two grafts, while three grafts were juxtaposed in a third patient in order to treat larger lesions. There was no mortality related to the procedure, although one patient (6.2%) died because of multiorgan failure 24 h post-operatively. The placement of the graft was successful in all cases except one affected with type B dissection and characterized by a very large intimal flap, which was eventually fenestrated by graft guidewire. Therefore, an optimal sealing of the grafts was achieved in 15 patients. However, in one patient the descending aorta had to be surgically replaced because of the calcified pseudoaneurysm still compressing the trachea and left bronchus. Two patients required a left carotid-subclavian bypass in order to achieve a sufficient neck for the proximal placement of the graft. No spinal cord injuries were observed. At the follow-up, performed with chest spiral angio-CT scan within 72 h and scheduled at 6 and 12 months and once a year, no stent-graft related complications have been detected. Conclusions: Endoluminal stent-graft treatment may represent a valid option in well-selected cases of descending thoracic aorta diseases. A longer follow-up in a larger series of patients is desirable to confirm these initial positive results. q 2001 Elsevier Science B.V. All rights reserved. |
| Databáze: | OpenAIRE |
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