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Analysis of Early and Distant Results Following Endovascular Repair of the Descending and Abdominal Aorta

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Mazurkiewicz A., Andziak P., Sybilski M., Nowicki M., Dratwicki M., Braun K., Zdzienicki M., Walecki J.
Polish Journal of Surgery
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2007
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vol. 79
|
issue 3
209-217
EN
The aim of the study was to analyze early and distant results following thoracic descending and abdominal aorta stentgraft implantations.Material and methods. During the period between 2000 and 2006, 20 stentgrafts were implanted into the thoracic descending aorta and 114 into the abdominal aorta.Results. The initial technical success was obtained in 85.71% of cases considering the descending aorta and 89.47% in case of the abdominal aorta. The initial clinical success was obtained in 85.71% and 84.21%, respectively. In 5% of descending aortic operations the branching of the left subclavian artery was covered. Early mortality in case of descending aortic operations amounted 4.76%, while that after abdominal aortic operations - 0.88%. After the implantation of abdominal aortic stentgrafts, 2.63% of early conversions were performed because of aneurysmal rupture, and 1.75% of distant conversions, due to prosthesis inflammation. After abdominal aortic operations, 2.63% of patients required reconstructive operations, due to arterial injury at the site of the approach. After the implantation of descending aortic stentgrafts, early type 1 endoleaks were observed in 10% of cases. After the implantation of abdominal aortic stentgrafts, primary endoleaks were observed in 11.4% of cases: type 1 - 7.02%, type 2 - 3.51%, type 3 - 0.88%. Following the implantation of abdominal aortic stentgrafts, 1.75% of patient's demonstrated symptoms of colon ischemia, while 0.88% - kidney ischemia. After abdominal aortic operations secondary endoleaks were observed in 7.01% of cases: type 1 - 2.63%, type 2 - 1.75%, type 3 - 2.63%.Conclusions. 1. The implantation of stentgrafts is a safe and effective method considering the treatment of descending aortic injuries, dissections and ruptures. 2. The implantation of stentgrafts enables to obtain satisfactory results in the treatment of abdominal aortic aneurysms, considering high-risk patients. 3. The significant number of complications and their heterogenity might be responsible for the limited indications towards stentgraft implantations. The above-mentioned method should be performed in case of patients, where classical operations are connected with an increased risk of complications.
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