Abstract No. 239: Non-Aneursymal Acute Aortic Syndromes – 3D CT Imaging Features for Interventional Management

Abstract

To review and audit our single institution experience to-date in endovascular repair of thoracic aortic pathology. A formal thoracic aortic stent programme was inititated in June 2006 by the radiology department in collaboration with the national cardiothoracic center and vascular surgery departments. Prior to this a number of stents had been performed electively by the cardiology and cardiothoracic services. We prospectively recorded the patients treated by radiology and retrospectively reviewed clinical, imaging and follow up data on all patients. A total of 29 patients were treated over 2 years. The underlying thoracic conditions included aneurysm, dissection, pseudoaneurysm, transaction and aorto-bronchial fistula. Radiology performed 10 stents in 9 patients over 12 months and all the emergency cases. 8 TAG (Gore), 2 Palmaz and 6 Valiant (Medtronic) stents were employed. Cardiology performed 14 Palmaz stents for Coarctations. All had pre-procedure and follow-up 2D and 3D CT angiography. All patients had successful stenting procedures. There was one death in a patient of high risk and multiorgan dysfunction pre-procedure. There were 2 stent foldings/kinks one of which required angioplasty and balloon mounted stent. There were no stent migrations or endoleaks. There was no paraparesis or paralysis from stent procedures. Non-stent complications included 1 surgical bypass which thrombosed requiring re-operation. Thoracic aortic stenting has been performed with consistent clinical success in our institution for a variety of non-aneurysmal aortic pathologies. Results compare favourably to international standards. The radiology department has provided a reliable diagnostic and therapeutic service over the last 12months with good results in the elective and emergency setting.