OBJECTIVE: To report mid-term results of stent-graft (SG) implantation in acute thoracic aortic rupture as alternative to conventional open surgery with its associated high morbidity and mortality rates. METHODS: Out of a series of 69 patients undergoing thoracic aortic SG implantation since 1998, 24 (mean age 57+/-19 years, range 20-85-years-old) patients were treated on an emergency basis for hemorrhage control. The indication for SG placement was acute traumatic aortic rupture in 15 patients, type B dissection with contained rupture in 3 patients, penetrating aortic ulcer with periaortic hematoma in 3 patients, and thoracic aortic aneurysm rupture in 3 patients. Preoperative assessment was done by computed tomography (CT) scanning and echography. Patients were treated in the angiography suite by implantation of Excluder (n = 18) Talent (n = 4) Corvita (n = 1) and Vanguard (n = 1) self-expanding grafts. Local anesthesia was the most frequently used anaesthesiologic technique. RESULTS: Technical success rate of SG deployment was 100%. The early postoperative mortality was 12.5% (3 of 24). One patient suffered temporary paraplegia (4%). There was no intervention-related mortality during the mean follow-up of 34.1 months. Two secondary endoleaks were successfully treated with additional SG placement at 2 and 12 months postoperative, respectively. CONCLUSIONS: Emergency SG repair to control hemorrhage in patients with an acute thoracic aortic rupture is a less-invasive attractive and rational treatment option, especially if associated lesions or co-morbidity may interfere with the surgical outcome. Long-term follow-up results will be helpful to clarify procedure durability bounded by material failure and postoperative aneurysm or aortic wall remodelling.
OBJECTIVE: To report mid-term results of stent-graft (SG) implantation in acute thoracic aortic rupture as alternative to conventional open surgery with its associated high morbidity and mortality rates. METHODS: Out of a series of 69 patients undergoing thoracic aortic SG implantation since 1998, 24 (mean age 57+/-19 years, range 20-85-years-old) patients were treated on an emergency basis for hemorrhage control. The indication for SG placement was acute traumatic aortic rupture in 15 patients, type B dissection with contained rupture in 3 patients, penetrating aortic ulcer with periaortic hematoma in 3 patients, and thoracic aortic aneurysm rupture in 3 patients. Preoperative assessment was done by computed tomography (CT) scanning and echography. Patients were treated in the angiography suite by implantation of Excluder (n = 18) Talent (n = 4) Corvita (n = 1) and Vanguard (n = 1) self-expanding grafts. Local anesthesia was the most frequently used anaesthesiologic technique. RESULTS: Technical success rate of SG deployment was 100%. The early postoperative mortality was 12.5% (3 of 24). One patient suffered temporary paraplegia (4%). There was no intervention-related mortality during the mean follow-up of 34.1 months. Two secondary endoleaks were successfully treated with additional SG placement at 2 and 12 months postoperative, respectively. CONCLUSIONS: Emergency SG repair to control hemorrhage in patients with an acute thoracic aortic rupture is a less-invasive attractive and rational treatment option, especially if associated lesions or co-morbidity may interfere with the surgical outcome. Long-term follow-up results will be helpful to clarify procedure durability bounded by material failure and postoperative aneurysm or aortic wall remodelling.
Authors: I E Steingruber; B V Czermak; A Chemelli; B Glodny; J Bonatti; W Jaschke; P Waldenberger; M Rieger; B Neuhauser Journal: Eur Radiol Date: 2006-11-18 Impact factor: 5.315
Authors: Václav Procházka; Jan Roman; František Jalůvka; Tomáš Jonszta; Adéla Vrtková; Leopold Pleva; Vladimír Ječmínek; Jiří Sieja; Radim Brát Journal: Med Sci Monit Date: 2021-11-11
Authors: Kyung Yun Kim; Seung Jae Byun; Kyeong Ho Yun; Sam Youn Lee; Dae Woong Ryu; Sang Jae Rhee; Byung Jun So Journal: J Korean Surg Soc Date: 2012-04-26