ENDOVASCULAR REPAIR IN MANAGEMENT OF THORACIC AND ABDOMINAL AORTIC PATHOLOGIES

Purpose: Aneurysms, dissections and ruptures of the thoracic and abdominal aorta are still potentially life-threatening situations. The conventional operation is still associated with morbidity. Endovascular stent graft repair offers an alternative to conventional operation for management of these aortic diseases. Our aim was to report our experience with endovascular stent graft repair of thoracic and abdominal aortic diseases.

Methods: Between April 2004 and March 2007, endovascular stent graft repair was performed in 41 patients. The lesions were in the thoracic aorta in 11 patients and abdominal aorta in 30 patients. In 16 of the 41 patients there were emergent situations. In the postoperative period control CT scans were evaluated in the day of discharge, 3 rd, 6 th and 12 th months after the procedure.

Results: The mean age was 73.7 ± 16.3 ( 38-86) years. The deployed stent graft systems were Talent-Medtronic(n=12), Excluder- Gore (n=27) and Jotec E-vita (n=2). Successful deployment of the stent grafts in the appropriate position was achieved in all patients. There hospital mortality occured in 3 patients and hemiparesis in one patient. There was no conversion to open surgery. Mean follow up time was 17.1±5.4 months. The total number of endoleaks were 9 (21.9 %).

Conclusion: Endovascular stent graft placement is a feasible and effective approach in the treatment of patients with complicated pathologies of both thoracic and abdominal aorta even in emergent pathologies. The endoluminal approach can avoid the major trauma of surgical therapy. However the long term results will determine the future of this treatment despite the encouraging short and mid-term results. (Turkish J Vasc Sur 2008;17(1):21-26).