Outcomes of Endovascular Repair of Ruptured Descending Thoracic Aortic Aneurysms

Article

关键词: STENT-GRAFT PLACEMENT;    OPEN SURGERY;    ENDOLEAKS;    INTERVENTIONS;    METAANALYSIS;    DISSECTION;    REGISTRY;    DISEASE;    TRIAL;    RISK;   

DOI  :  10.1161/CIRCULATIONAHA.109.908871

来源: SCIE

【 摘 要 】

Background-Thoracic endovascular aortic repair offers a less invasive approach for the treatment of ruptured descending thoracic aortic aneurysms (rDTAA). Due to the low incidence of this life-threatening condition, little is known about the outcomes of endovascular repair of rDTAA and the factors that affect these outcomes. Methods and Results-We retrospectively investigated the outcomes of 87 patients who underwent thoracic endovascular aortic repair for rDTAA at 7 referral centers between 2002 and 2009. The mean age was 69.8 +/- 12 years and 69.0% of the patients were men. Hypovolemic shock was present in 21.8% of patients, and 40.2% were hemodynamically unstable. The 30-day mortality rate was 18.4%, and hypovolemic shock (odds ratio 4.75; 95% confidence interval, 1.37 to 16.5; P = 0.014) and hemothorax at admission (odds ratio 6.65; 95% confidence interval, 1.64 to 27.1; P = 0.008) were associated with increased 30-day mortality after adjusting for age. Stroke and paraplegia occurred each in 8.0%, and endoleak was diagnosed in 18.4% of patients within the first 30 days after thoracic endovascular aortic repair. Four additional patients died as a result of procedure-related complications during a median follow-up of 13 months; the estimated aneurysm-related mortality at 4 years was 25.4%. Conclusion-Endovascular repair of rDTAA is associated with encouraging results. The endovascular approach was associated with considerable rates of neurological complications and procedure-related complications such as endoleak. (Circulation. 2010; 121: 2718-2723.)

【 授权许可】

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