Endovascular stent-grafting of descending thoracic aortic lesions

Objective: To discuss the feasibility of endoluminal stent-grafting for descending thoracic aortic lesions.

Methods: 12 patients underwent stent-grafting of the thoracic aorta with Talent (11 patients) and Vanguard (1) device. Endovascular technique was used in 12 patients with descending thoracic aortic aneurysms (5 patients), Stanford B dissections (6), and pseudoaneurysm (1). 13 straight stent-grafts were inserted through 18-24 F theaths via a femoral arteriotomy under local (2 patients) or general (10) anesthesia.

Results: The procedure was technically successful in all patients without aneurysm rupture, paraplegia, and organs or limbs ischemia. There were 3 early endoleaks. Follow-up showed that 4 of 5 aortic aneurysms were excluded completely and one endoleak was changed into persistent. Four entries of 6 patients with stanford B dissection were excluded and 2 early endoleaks were sealed during one month after operation. Four false lumen were filled completely and 2 false lumen were filled partly by thrombosis.

Conclusions: Descending thoracic aortic stent-grafting is a safe, highly successful and feasible alternative to conventional surgery. The long-term result remains unclear, especially that of the endovascular repair of Stanford B dissection.