Mid-term results of endovascular treatment with the Gore TAG device for degenerative descending thoracic aortic aneurysms.

Objective: To confirm the validity of using Gore TAG for degenerative descending thoracic aneurysm repair, we evaluated the mid-term clinical outcomes in our single-center experience.

Methods: From May 2008 to April 2011, elective thoracic endovascular aortic repair (TEVAR) with Gore TAG without left subclavian artery (LSA) coverage for a degenerative descending thoracic aneurysm was performed in 36 consecutive cases.

Results: The procedural success rate was 100%, and no patient died within 30 days of the operation. We observed no cases of paraplegia or stroke. The mean follow-up was 33.2 ± 13.0 months (the maximum follow-up was 58.0 months). The actuarial survival rate was 100, 97.2 and 94.4% at 1, 2 and 3 years. There was no aorta-related death at 3 years. Two (5.6%) late distal Type I endoleaks were observed. Freedom form aortic events rate was 97.2, 97.2, and 97.2% at 1, 2, and 3 years respectively. In six cases with bird-beak configurations at the 2-year follow-up, the bird-beak length and angle had increased gradually.

Conclusions: Elective TEVAR using the Gore TAG for degenerative descending thoracic aortic aneurysms without LSA coverage is effective and provides satisfactory early and mid-term outcomes. However, since the bird-beak configurations progressed, a conformable and flexible device for the next generation of procedures will be needed.