Thoracic CT Findings Following Endovascular Stent-Graft Treatment for Thoracic Aortic Aneurysm

Abstract

To investigate the transient computed tomographic (CT) findings and morphological characteristics of the descending thoracic aorta following endovascular repair of thoracic aortic aneurysm (TAA). Of 50 TAAs repaired using custom-made endoprostheses between May 1997 and September 2005, 35 (25 men; mean age 67 years) were successfully treated and followed for >3 months by thoracic CT. The TAA etiologies were 22 degenerative/atherosclerotic, 7 dissection-related from intramural hematoma, 2 traumatic, 2 anastomotic, and 2 penetrating ulcers. The CT findings following stent-graft placement were retrospectively studied. Over a mean follow-up of 27.0+/-25 months (range 3-92), periaortic changes were observed in 17 (48.6%) patients, and the amount of pleural effusion increased in 13 (37.1%). In all cases, these findings disappeared without specific treatment during the follow-up period. Late secondary endoleak was observed in 1 (2.9%) patient, and there was 1 (2.9%) caudal migration of the proximal end of the stent-graft. Five (14.3%) aneurysms increased in size. Two patients, both with dissection, showed aortic neck dilatation. There was a positive relationship between neck dilatation and dissection-related TAA etiology (p = 0.035). Although aortic neck dilatation is less common after endovascular TAA repair than after abdominal repairs, patients with dissection-related TAA may be a subgroup prone to aneurysm neck dilatation.