Endovascular Exclusion of Thoracic Aortic Aneurysms
| Autor: | X. Kapfer, F. Liewald, Johannes Görich, R. Scharrer-Pamler, Ludger Sunder-Plassmann, Karl-Heinz Orend |
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| Rok vydání: | 2003 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Time Factors medicine.medical_treatment Ischemia Prosthesis Design Blood Vessel Prosthesis Implantation Aneurysm medicine.artery medicine Humans Thoracic aorta Multislice cardiovascular diseases Common carotid artery Aged Aortic Aneurysm Thoracic business.industry Angiography Stent medicine.disease Operating table Surgery Treatment Outcome Elective Surgical Procedures Female Stents Radiology Tomography X-Ray Computed Cardiology and Cardiovascular Medicine business Subclavian steal syndrome Follow-Up Studies |
| Zdroj: | Journal of Cardiac Surgery. 18:367-374 |
| ISSN: | 0886-0440 |
| DOI: | 10.1046/j.1540-8191.2003.02077.x |
| Popis: | Purpose: The purpose is to present results of endovascular exclusion (stent-graft treatment) of aneurysms of the descending thoracic aorta both in elective cases and in emergencies. Methods: Indications for stent-graft treatment were dependent on multislice angio-CT evaluation revealing a proximal neck of at least 10 mm between the left common carotid artery and the onset of aneurysm. All stent grafts were inserted in the operating room; 43 transfemoral, 2 transiliac. The stent grafts used were Corvita, Stenford, Vanguard, AneuRx, Talent, and Excluder. Deployment was achieved under fluoroscopic control, endoleaks were checked for with D S A on the operating table and postoperatively by angio-CT. Long-term follow-up consisted of evaluation with angio-CT after 6 and 12 months, and from there on once a year and with plain chest X-rays. Follow-up was achieved in all patients. Results: Mean follow-up is 21 months (1–66); 30-day mortality is 3/45, no permanent neurologic deficit. Thirty patients were treated electively, 15 with contained rupture. Left subclavian artery overstenting proved to be necessary in 12 patients for proper proximal sealing of the aneurysm, type I endoleaks were observed in 10 patients, one early conversion, 7 proximal extension cuffs, one sealed spontaneously, one still at risk. Among patients where LSA had been overstented only one wanted a transposition, all others did well without left-hand ischemia or subclavian steal syndrome. Conclusion: Endovascular treatment is less invasive and has reasonable mortality and morbidity but is limited to well-defined morphologies. Mid-term results are promising but it has to be observed whether these will translate into long-term durability. (J Card Surg 2003; 18:367-374) |
| Databáze: | OpenAIRE |
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