OC24 ENDOVASCULAR SURGERY FOR ACUTE THORACIC AORTIC SYNDROMES

Abstract

Background and Aim: Surgery of thoracic aortic emergencies is challenging and carries significant high morbidity and mortality rate. In the last decade, Thoracic EndoVascular Aortic Repair (TEVAR) has shown improved early and late outcome, mostly in emergency. To assess early and long-term results after TEVAR for thoracic aortic emergencies we retrospectively reviewed our experience. Methods: From March 2001 to March 2018, out of 289 patients undergone TEVAR, we retrospectively reviewed 191 patients, 164 (85.9%) men; aged from 19 to 84 years, treated in urgent/emergent conditions: 51 patients (26.7%) for contained or free rupture of degenerative aneurysms, 118 (61.8%) for complicated acute or chronic type B aortic dissections and 22 (11.5%) for traumatic aortic injuries. Results: The overall 30 days mortality was 4.4% (8 patients). Open surgical conversion was not required.. Periprocedural complications included arterial rupture or dissection (5.7%; 11 patients) and TIA/stroke (1.6%; 3 patients). Left subclavian artery (LSA) overstenting was achieved in 79 patients (41.3%). Follow-up ranged from 2 to 204 months and included clinical examinations and serial CT-scan. There were 8 late deaths aorta-related (4.4%). A secondary endovascular procedure was required in 13 pts (7.1%). One patient (0.5%), with retrograde aortic dissection, required open surgery. No patient with LSA overstenting required a secondary revascularization or showed subclavian steal phenomenon. Conclusions: The early and mid-term technical and clinical results supports the safety and effectiveness of thoracic endovascular surgery in patients with acute aortic syndromes too. More cases and longer follow-up are required.