Endovascular Stent Graft Treatment in Thoracic Aortic Aneurysmal Disease

Abstract

Purpose: The frequency of thoracic endovascular aortic repair (TEVAR) is increasing due to lower morbidity and mortality than that of open repair. The aim is to evaluate the results of TEVAR in patients with thoracic aortic disease. Methods: Twenty seven patients have undergone TEVAR from October, 2003 to November, 2012. Aortic diagnoses were 7 descending thoracic aortic aneurysms, 6 acute descending aortic dissections, 6 traumatic aortic transactions, 4 aortic arch aneurysms, 2 chronic descending aortic dissections, and 2 penetrating aortic ulcers (PAU). Multi detector computerized tomography (MDCT) aortography was done at one week, one month, six months, and one year interval. Results: Indications for TEVAR were aortic diameter of more than 5.5 cm in 9 patients, traumatic aortic transaction in 6, persistent chest pain in 4, increasing aortic diameter during follow-up period in 3, aneurysm rupture in 3, and PAU more than 2 cm in 2. Hybrid TEVAR was done in 7 patients. Primary technical success, showing complete aneurysmal exclusion, was done except in one patient (96%). There was one operation death (4%). Two patients developed perioperative stroke, but recovered without sequelae. MDCT was done during the mean of 18 months (range, 1 to 98 months) follow-up period. Small type I endoleak was found in two patients (7%), and type III endoleak was found in a patient (4%). Stent graft migration was in one patient. There was no aorta related deaths during the follow-up period. Conclusion: Intermediate term result of TEVAR in patients with thoracic aortic aneurysmal disease was encouraging. It may be used as a treatment option for thoracic aortic disease.