Endovascular Repair of Thoracic Aortic Disease with the EndoFit Stent-Graft: Short and Midterm Results from a Single Center

• Published in: Journal of endovascular therapy 2008-02, Vol.15 (1), p.54-61
• Main Authors: Inglese, Luigi, Mollichelli, Nadia, Medda, Massimo, Sirolla, Cristina, Tolva, Valerio, Grassi, Viviana, Fantoni, Cecilia, Neagu, Ana, Pavesi, Marco
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Aneurysms; Aorta, Thoracic; Aortic Diseases - mortality; Aortic Diseases - surgery; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation - methods; Coronary vessels; Disease Progression; Female; Hospital Mortality; Hospitals; Humans; Intensive care; Male; Middle Aged; Mortality; Postoperative Complications; Prosthesis Design; Retrospective Studies; Stents; Survival Analysis; Treatment Outcome
• ISSN: 1526-6028; 1545-1550
• DOI: 10.1583/07-2158M.1

Purpose: To analyze the outcomes of endovascular treatment of thoracic aortic pathologies performed at a single center with the EndoFit thoracic stent-graft system. Methods: From January 2002 to January 2007, 41 patients (33 men; mean age 69.3±9.7 years, range 48–84) were treated for thoracic aortic disease with the EndoFit stent-graft system. Patient data were retrieved from a retrospective review of hospital records. Indications for treatment were progression of aneurysm size in atherosclerotic aneurysms (n=24, mean aneurysm diameter 7.19±1.48 cm), acute contained aortic rupture (n=5), aortic dissection (n=6), penetrating atherosclerotic ulcers (n=4), post-traumatic pseudoaneurysm (n=1), and post coarctation repair aneurysm (n=1). Results: The EndoFit stent-graft was successfully deployed in all 41 patients. The inhospital and 30-day mortality rate was 7.3% (3 patients). Three (7.3%) postoperative endoleaks were recorded: a proximal type Ia and a distal Ib both resolved spontaneously at 1 and 3 months, respectively. The third patient had a persistent type Ia endoleak; conversion was necessary after 1 year. There was only 1 case of spinal ischemia, with consequent lower extremity weakness; no paraplegia was observed. During a mean 24.8-month follow-up, 2 secondary type Ia endoleaks were treated with additional stent-grafts. There were 7 (17%) deaths during follow-up. At 2 years, overall patient survival by KaplanMeier analysis was 70%; aneurysm-related survival was 89%. Conclusion: Endovascular treatment of vascular disease involving the descending thoracic aorta can be safely performed with the EndoFit thoracic stent-graft system.