Endovascular treatment of thoracic aortic disease: Mid-term follow-up

Objective: The aim of this study was to evaluate the mid‐term follow‐up in a cohort of patients with acute or chronic descending aortic disease treated by stent‐graft repair. Background: Since 1999, endovascular stent‐graft placement has been reported as an alternative treatment to surgical approach for a variety of thoracic aortic diseases; however, results beyond initial short‐term follow‐up are not widely available for the broad range of applications. Methods: From March 2001, 43 consecutive patients with traumatic aortic transection (group A = 16) and complicated type B aortic dissection or aneurysm (group B = 27) underwent stent‐graft implantation. All patients underwent computed tomography (CT) scan as preoperative assessment and in 26 a transesophageal echo (TEE) exam was performed. Results: Technically successful stent‐graft deployment was achieved in all patients. No patient required surgical conversion and no cases of paraplegia occurred. The overall in‐hospital mortality was 9.3%. A residual endoleak (type II) was detected in one group B patient who was managed conservatively. The mean follow‐up was 29 ± 8 months (range 10–48 months). No patient died during late follow‐up after hospital discharge. At 12 months, one patient (2.5%) who had stent graft repair of an aortic dissection developed an asymptomatic type I endoleak. Three asymptomatic patients with chronic dissection had a persistent retrograde perfusion of the thoracic false lumen via a distal tear(s) in the dissection septum. Conclusion: Our results of stent‐graft treatment of complicated and uncomplicated diseases of the descending aorta confirms that this alternative to open repair is a safe, less invasive, and relatively low risk approach. Medium‐term follow‐up results suggest that it is effective and durable therapy with low associated mortality and morbidity rates. © 2007 Wiley‐Liss, Inc.