Abstract:
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%. CONCLUSIONS: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.
journal_name
Circulationjournal_title
Circulationauthors
Jonker FH,Verhagen HJ,Lin PH,Heijmen RH,Trimarchi S,Lee WA,Moll FL,Athamneh H,Muhs BEdoi
10.1161/CIRCULATIONAHA.109.908871subject
Has Abstractpub_date
2010-06-29 00:00:00pages
2718-23issue
25eissn
0009-7322issn
1524-4539pii
CIRCULATIONAHA.109.908871journal_volume
121pub_type
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