Long-term experience with endovascular therapy of the descending thoracic aorta

Background To review single centre experience of endovascular treatment of descending thoracic aorta. Methods Between May 1999 and September 2012, 72 patients were treated overall (53 men, 19 women, mean age 60.1 years) for degenerative aneurysms (n = 5), ruptured aneurysms (n = 4), aortic ulcers (n = 8), infected aneurysms (n = 4), type B aortic dissections (n = 23), and traumatic aortic injuries (n = 28). Results The technical success rate was 98.6%, 30-day mortality was 8.3%, 1-year mortality was 13.8%, and overall mortality was 22.2%. Mortality caused by the treatment of aortic diseases was 6.9%. Permanent stroke occurred in 1 patient, and paraplegia developed in 1 patient. In a group of 23 patients whose left subclavian artery (LSA) was covered, claudication of the left upper extremity developed in 2 cases. Conclusions Endovascular therapy offers a very effective and less invasive alternative to the surgical approach for a wide range of the thoracic aortic disease. The main advantage of using TEVAR seems to be in acute conditions when a stent graft stabilizes the aorta and prevents further bleeding and organ ischemia. Regular follow-up is mandatory for early recognition of specific TEVAR complications.