AIM: Determination of the conditions for good acute and long term results of interventional therapy of lesions of the thoracic aorta using stent-grafts.
PATIENTS, MATERIAL AND METHODS: 51 patients with aneurysm of the thoracic aorta (type B dissections) covered rupture and aortobronchial fistula were evaluated. All cases were discussed in an interdisciplinary conference consisting of thoracic surgeon and interventional radiologist. Primarily, 20 patients were operated and 31 were treated by intervention. For all a multidetector row CT angiography was ordered prior to the discussion. All procedures were performed in a DSA suite under general anaesthesia. In 29 patients Talent LPS trade mark tube grafts and in four patients an Excluder trade mark graft was implanted.
RESULTS: 29 patients had an aneurysm of the thoracic aorta, 21 a type B dissection, 19 a perforation and one patient had an aortobronchial fistula. The follow up was 13.4 months. In 29 patients the stent-graft implantation was successful, in 2 patients stent-graft delivery failed due to severe calcification and kincking of both common iliac arteries. One patient had an iliacal dissection after stent-graft delivery which was treated successfully by surgery. In two patients CT angiographic control detected endoleaks, which were treated with a second stent-graft placement. One patient with an acute perforation of the descending aorta died due to cardiac failure prior to stent-graft implantation. Any neurological complication did not occur.
CONCLUSION: Percutaneous treatment of lesions of the descending thoracic aorta using stent-grafts is a safe and feasible alternative treatment to surgical repair. Prior to the a multidetector row CT angiography is necessary for exact planning of the endo-luminal treatment.
Author(s): Thalhammer A, Balzer J, Doss M, Jacobi V, Vogl T.
in: Hamostaseologie. 2004 Aug;24(3):157-61
PMID: 15314699 [PubMed - indexed for MEDLINE]
