Endoluminal stent grafts for aortic diseases: experience at a major teaching hospital in Hong Kong

Abstract

The purpose of the present paper was to review the initial experience of an endovascular aortic stent graft program at a major teaching hospital in Hong Kong. Demographics, operative details, complications and follow-up data of all the patients receiving endovascular repair for aortic disease were recorded prospectively. Between July 1999 and December 2001, endovascular repairs were attempted in 39 patients with aortic disease. The procedural success rate was 97.4%. Thirty-three procedures were for abdominal aorto-iliac aneurysms. Graft configuration was bifurcated in 28 patients (85%) while an aorto-uni-iliac device with a femoro-femoral bypass was carried out in the remaining five patients. Thoracic procedures were carried out for one thoracic aortic aneurysm, two traumatic thoracic aortic injuries, one thoracic aortic dissection, and one thoracic aortic pseudoaneurysm with aorto-oesophageal fistula. There was one hospital mortality (2.6%) from a type A thoracic aortic dissection with cardiac tamponade. Postoperative complications were seen in seven patients (18%). With a mean follow-up of 11.6 +/- 8.1 months, there was no open conversion or rupture. The endoleak rate was 27% at discharge, 15% at 6 months and 5% at 12 months postoperatively. For aneurysm endografts, the aneurysm sac decreased in size in 21 patients (62%), and remained static in 13 patients (38%). The endoluminal stent graft appears to be a promising device that can be used safely in selected patients with aortic disease. Continued follow-up is required to monitor the presence of endoleak and the size of the aneurysm sac.