J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract]

J.Jpn. Surg. Soc.. 100(8): 500-505, 1999

Feature topic

EARLY AND MID-TERM RESULTS OF ENDOVASCULAR STENT GRAFTING FOR AORTIC ANEURYSMS

1) Dept. of Thoracic and Cardiovascular Surgery, Mie University School of Medicine, Tsu, Japan
2) Dept. of Radiology, Mie University School of Medicine, Tsu, Japan
3) Dept. of Radiology, Matsuzaka Chuo Hospital, Matsuzaka, Japan

Takatsugu Shimono1), Noriyuki Kato2), Tadanori Hirano3), Kan Takeda2), Isao Yada1)

Early and mid-term clinical results of 28 cases of endovascular stent grafting for descending thoracic aortic aneurysms and 11 cases of abdominal aortic aneurysms are reported.
Early clinical results : Among 28 patients (7 true thoracic aortic aneurysms, 3 pseudothoracic aortic aneurysms and 8 acute, 4 subacute, and 6 chronic aortic dissections), two patients (7.1％) with ruptured acute aortic dissection or ruptured infected pseudoaneurysm died in the perioperative period. Two of the remaining 26 patients experienced minor complications. Aneurysmal sacs or false lumens at the descending thoracic aorta were completely thrombosed in the 26 patients. One patient (9.1％) with a ruptured abdominal aneurysm died, and one of the remaining 10 patients had renal and peripheral emboli and peripheral vascular trauma. Inadvertent covering of the renal arteries occurred in another patient. Unless one patient had persisterlt endoleak, aneurysmal sacs in the 10 surviving patients were thrombosed.
Mid-term clinical results : One aortic dissection at a different section of the descending aorta occurred 6 months after stent grafting for aortic dissection, and one patient died of pneumonia 3 months after stent grafting for an abdominal aortic aneurysm. CT scaning 6 months after stent grafting revealed a decrease in maximal aneurysmal size in 3 of 9 patients with true or pseudothoracic aneurysms and in 2 of 5 patients with abdominal aortlc aneurysms. Five of 9 patients with stent grafting for acute or subacute dissection showed elimination of the false lumen in the descending thoracic aorta in a CT scan 6 months after grafting. One patient with a true thoracic aneurysm and one patient with an abdominal aortic aneurysm showed an increase in aneurysmal size in a CT scan 2 years and one year after treatment, respectively.

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