Results of endovascular repair of the thoracic aorta with the Talent Thoracic stent graft: the Talent Thoracic Retrospective Registry

Abstract

Conclusion: The Talent thoracic stent graft appears effective in the treatment of both acute and chronic diseases of the thoracic aorta. Summary: This report derives from the Talent Thoracic Retrospective Registry. It includes treatment of patients in seven major European referral centers during an 8-year period. The Talent thoracic stent graft was used to treat thoracic aortic pathology in 457 consecutive patients, of which 113 were emergent cases and 344 were elective. Median follow-up was 24 ± 19 months (range, 1 to 85.1 months). Follow-up was based on clinical and imaging findings. Adverse events were included, and all adverse events were reviewed by a single physician. In-hospital mortality was 5% (23 patients). Mortality was 8.5% during follow-up of the 422 patients who survived the initial procedure. Thirty-six patients died, and 11 of the deaths were related to aortic disease. Specific procedure-related complications included stroke in 3.7%, paraplegia in 1.7%, and local vascular access-site complications in 3.3%. Two patients died of aortic rupture during placement of the device. Persistent endoleak was documented in 64 cases, of which 43 demonstrated primary endoleak present at the end of the procedure, and 21 endoleaks were discovered during follow-up. There were 7 patients with persistent endoleak with aortic rupture during the follow-up period. Aortic rupture associated with persistent endoleak occurred from 40 days to 35 months. All patients with aortic rupture associated with persistent endoleak died. Stent graft migration occurred in seven cases, graft fabric failure in two, and known modular disconnection in three. Survival was 90.97% at 1 year, 85.36% at 3 years, and 77.49% at 5 years. Freedom from a second procedure, endovascular, or open conversion, at 1, 3 and 5 years was 92.41%, 81.3%, and 70.0%, respectively. Comment: These are registry data and are thus subject to all the limitations of such data. Patients were treated for a variety of acute and chronic conditions. Although patients were acquired during an 8-years period, only 95 patients had >3 years of clinical and imaging follow-up available. The data suggest the Talent thoracic aortic stent graft can be deployed with a reasonable rate of complications for a variety of thoracic aortic pathologies. Further follow-up is obviously required to establish long-term efficacy.