Endovascular stent-graft treatment for diseases of the descending thoracic aorta

A. S. Bortone, Stefano Schena, G. Mannatrizio, V. Paradiso, G. Ferlan, G. Dialetto, M. Cotrufo, L. De Luca Tupputi Schinosa

Research output: Contribution to journalArticle

Abstract

Objective: Assessment of endovascular stent-graft treatment for diseases of the descending thoracic aorta as a valid and effective alternative to surgery. Methods: From March 1999 to August 2000, a total of 16 patients underwent deployment of endovascular stent-grafts in the descending thoracic aorta. Patients were divided into three groups according to the type of lesion. Group A (n=8) included five patients with atherosclerotic aneurysm and three with chronic post-traumatic pseudoaneurysm. Patients with acute post-traumatic pseudoaneurysm (n=3) and type B aortic dissection (n=5) were included in Groups B and C, respectively. All patients underwent 5-mm chest spiral angio-computerized tomography (CT) scan and angiography as preoperative assessment. The deployed stent-graft systems were Talent™-Medtronic and Excluder®-Gore. Results: A total of 20 stent-grafts were placed. Two patients required deployment of two grafts, while three grafts were juxtaposed in a third patient in order to treat larger lesions. There was no mortality related to the procedure, although one patient (6.2%) died because of multiorgan failure 24h post-operatively. The placement of the graft was successful in all cases except one affected with type B dissection and characterized by a very large intimal flap, which was eventually fenestrated by graft guidewire. Therefore, an optimal sealing of the grafts was achieved in 15 patients. However, in one patient the descending aorta had to be surgically replaced because of the calcified pseudoaneurysm still compressing the trachea and left bronchus. Two patients required a left carotid-subclavian by-pass in order to achieve a sufficient neck for the proximal placement of the graft. No spinal cord injuries were observed. At the follow-up, performed with chest spiral angio-CT scan within 72h and scheduled at 6 and 12 months and once a year, no stent-graft related complications have been detected. Conclusions: Endoluminal stent-graft treatment may represent a valid option in well-selected cases of descending thoracic aorta diseases. A longer follow-up in a larger series of patients is desirable to confirm these initial positive results.

Original languageEnglish (US)
Pages (from-to)514-519
Number of pages6
JournalEuropean Journal of Cardio-thoracic Surgery
Volume20
Issue number3
DOIs
StatePublished - Aug 23 2001
Externally publishedYes

Fingerprint

Thoracic Aorta
Stents
Transplants
False Aneurysm
Therapeutics
Spiral Computed Tomography
Dissection
Thorax
Thoracic Diseases
Tunica Intima
Aptitude
Bronchi
Trachea
Spinal Cord Injuries
Aneurysm
Angiography
Neck

Keywords

  • Aortic aneurysm
  • Aortic dissection
  • Aortic pseudoaneurysm
  • Endovascular stent-grafts

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Bortone, A. S., Schena, S., Mannatrizio, G., Paradiso, V., Ferlan, G., Dialetto, G., ... De Luca Tupputi Schinosa, L. (2001). Endovascular stent-graft treatment for diseases of the descending thoracic aorta. European Journal of Cardio-thoracic Surgery, 20(3), 514-519. https://doi.org/10.1016/S1010-7940(01)00829-6

Endovascular stent-graft treatment for diseases of the descending thoracic aorta. / Bortone, A. S.; Schena, Stefano; Mannatrizio, G.; Paradiso, V.; Ferlan, G.; Dialetto, G.; Cotrufo, M.; De Luca Tupputi Schinosa, L.

In: European Journal of Cardio-thoracic Surgery, Vol. 20, No. 3, 23.08.2001, p. 514-519.

Research output: Contribution to journalArticle

Bortone, AS, Schena, S, Mannatrizio, G, Paradiso, V, Ferlan, G, Dialetto, G, Cotrufo, M & De Luca Tupputi Schinosa, L 2001, 'Endovascular stent-graft treatment for diseases of the descending thoracic aorta', European Journal of Cardio-thoracic Surgery, vol. 20, no. 3, pp. 514-519. https://doi.org/10.1016/S1010-7940(01)00829-6
Bortone, A. S. ; Schena, Stefano ; Mannatrizio, G. ; Paradiso, V. ; Ferlan, G. ; Dialetto, G. ; Cotrufo, M. ; De Luca Tupputi Schinosa, L. / Endovascular stent-graft treatment for diseases of the descending thoracic aorta. In: European Journal of Cardio-thoracic Surgery. 2001 ; Vol. 20, No. 3. pp. 514-519.
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AU - Schena, Stefano

AU - Mannatrizio, G.

AU - Paradiso, V.

AU - Ferlan, G.

AU - Dialetto, G.

AU - Cotrufo, M.

AU - De Luca Tupputi Schinosa, L.

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N2 - Objective: Assessment of endovascular stent-graft treatment for diseases of the descending thoracic aorta as a valid and effective alternative to surgery. Methods: From March 1999 to August 2000, a total of 16 patients underwent deployment of endovascular stent-grafts in the descending thoracic aorta. Patients were divided into three groups according to the type of lesion. Group A (n=8) included five patients with atherosclerotic aneurysm and three with chronic post-traumatic pseudoaneurysm. Patients with acute post-traumatic pseudoaneurysm (n=3) and type B aortic dissection (n=5) were included in Groups B and C, respectively. All patients underwent 5-mm chest spiral angio-computerized tomography (CT) scan and angiography as preoperative assessment. The deployed stent-graft systems were Talent™-Medtronic and Excluder®-Gore. Results: A total of 20 stent-grafts were placed. Two patients required deployment of two grafts, while three grafts were juxtaposed in a third patient in order to treat larger lesions. There was no mortality related to the procedure, although one patient (6.2%) died because of multiorgan failure 24h post-operatively. The placement of the graft was successful in all cases except one affected with type B dissection and characterized by a very large intimal flap, which was eventually fenestrated by graft guidewire. Therefore, an optimal sealing of the grafts was achieved in 15 patients. However, in one patient the descending aorta had to be surgically replaced because of the calcified pseudoaneurysm still compressing the trachea and left bronchus. Two patients required a left carotid-subclavian by-pass in order to achieve a sufficient neck for the proximal placement of the graft. No spinal cord injuries were observed. At the follow-up, performed with chest spiral angio-CT scan within 72h and scheduled at 6 and 12 months and once a year, no stent-graft related complications have been detected. Conclusions: Endoluminal stent-graft treatment may represent a valid option in well-selected cases of descending thoracic aorta diseases. A longer follow-up in a larger series of patients is desirable to confirm these initial positive results.

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