Abstract
To determine whether access to extra-corporal circulation (ECC) is necessary to treat acute descending thoracic aorta disease. From January 2004 to May 2006, 16 patients underwent endovascular stent-graft repair of the descending thoracic aorta, among them 13 (81%) were treated in an emergency setting (nine men, mean age: 75.4 years, range 30-94 years). The indication was traumatic aortic rupture (n=3, 23%), complicated acute type B dissection (n=4; 31%), symptomatic or ruptured thoracic aortic aneurysm (n=4; 31%), aorto-esophageal fistula (n=1; 7,5%) and aortic intramural haematoma (n=1; 7,5%). Computed tomography showed hemomediastin and/or hemothorax in five patients (38%). Transesophageal echocardiography and angiography were performed in two (15%) and one patients respectively. Cerebrospinal fluid drainage was performed for two patients (15%). Endovascular repair was successfully completed in 92.3% of cases. The 30-day mortality was 7.5% (n=1). There was one case (7.5%) of delayed paraplegia. Follow-up ranged between two and 24 months (mean 10.2), no rupture occurred. Three type I endoleaks were detected and only two were treated. Two none related additional mortalities were observed. None of these patients has needed ECC....Continue Reading
References
May 20, 1999·The New England Journal of Medicine·C A NienaberA Pierangeli
Jul 25, 2000·Circulation·D H KoschykC A Nienaber
Aug 9, 2002·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Wolfram SchützJohannes Görich
Aug 9, 2002·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·John J BorsaSeher Demirer
Aug 7, 2003·The Annals of Thoracic Surgery·Mirko DossHans-Gerd Fieguth
Aug 7, 2003·Radiology·Rossella FattoriGiampaolo Gavelli
Nov 7, 2003·The Annals of Thoracic Surgery·Mirko DossAnton Moritz
Feb 5, 2004·The Annals of Thoracic Surgery·Gabriele IannelliNicola Spampinato
Apr 16, 2004·European Heart Journal·D ScheinertF W Mohr
Oct 16, 2004·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Michael BrandtJochen Cremer
May 4, 2005·The Journal of Thoracic and Cardiovascular Surgery·H RousseauP Otal
Dec 14, 2005·Circulation·Thomas T TsaiKim A Eagle
Apr 29, 2006·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Virginia GaxotteJean-Paul Beregi
Jul 22, 2006·Surgery·Roberto CaronnoPatrizio Castelli
Jul 29, 2006·The Journal of Thoracic and Cardiovascular Surgery·Rossella FattoriUNKNOWN Talent Thoracic Retrospective Registry
Dec 5, 2006·Journal of Vascular and Interventional Radiology : JVIR·Christine P ChaoW Andrew Oldenburg