ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Our endovascular therapy application for descending aortic pathology
Sefer Usta, Ergun Haliloğlu, Ümit Menteşe, Orhan Veli Doğan
Ahi Evren Göğüs Kalp Damar Cerrahisi Eğitim Araştırma Hastanesi, Kalp ve Damar Cerrahisi Kliniği, Trabzon, Türkiye
DOI : 10.5606/tgkdc.dergisi.2012.047
Background: This study aims to evaluate outcomes of endovascular therapy in patients with aortic aneurysm and type B dissection.

Methods: Between June 2009 and April 2011, 19 patients (15 males, 4 females; mean age 70.9±6.9; range 47 to 82 year) who underwent endovascular stent graft surgery in our clinic were included. The left subclavian artery was closed in eight patients. Three of them underwent left caroticosubclavian bypass.

Results: Thoracic stent grafting was performed under general anesthesia in seven patients, epidural anesthesia in 10 patients and local anesthesia in two patients. Seventeen patients had type B dissection, while two had aneurysm. One of the patients with dissection had right arcus aortic dissection. Another patient had a severe and complicated dissection interfering with peripheral intervention; therefore surgery was performed by stent grafting which was advanced reversely by a Dacron graft on ascending aorta following minimal sternotomy. The patient was monitored on day one following surgery. Mortality, stent migration, femoral/iliac arterial perforation and surgical site infection or hematomas were not present in the patients. Type 1 endoleak in one patient who underwent thoracic endovascular aortic repair (TEVAR) was detected by computed tomography (CT) performed at one-month following surgery. Repeated CT at three months revealed that leak was absent.

Conclusion: All patients should be definitely evaluated preoperatively for endovascular therapy. We believe that endovascular therapy is superior to surgery considering mortality, morbidity, cost-efficacy and comfort and should be the primary treatment of choice in certain patient groups.

Keywords : Descending aortic pathology; endovascular; stent graft
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