Endovascular stent-graft repair of complicated penetrating XXXX of the descending thoracic aorta.

@entity1 @entity451 @entity548 @entity1353 @entity1066 @entity397 @entity1410 @entity1282 @entity731 @entity5492 @entity2849
OBJECTIVE: To report our initial experience with endovascular stent-graft repair of complicated penetrating @entity731 as an alternative to surgery in @entity1 with increased risk of perioperative morbidity and mortality. METHOD: During a 2-year period, eight @entity1 with complicated penetrating @entity731 of the descending thoracic aorta were treated with the Gore Excluder stent-graft. @entity1 (mean age, 70.6 years) presented with two to five comorbid conditions causing an increased risk for surgical repair. In addition to painful events, three @entity1 presented with severe @entity5492 , one @entity1 with @entity1353 , and one @entity1 with @entity1282 . All @entity1 underwent emergency computed tomography, and diagnosis of contained @entity397 was confirmed in five @entity1 . Computed tomographic findings included one to three penetrating @entity1066 per @entity1 (n = 4), @entity2849 (n = 5), additional intramural @entity1410 (n = 4), @entity548 (n = 2), and hematothoraces (n = 4). Through an iliac or femoral access site, a total of 11 stent-grafts were implanted under general (n = 5), epidural (n = 2), or spinal (n = 1) anesthesia. RESULTS: Deployment of stent-grafts was successful in all @entity1 , and all sites of @entity548 were sealed. The intramural @entity1410 resolved completely in three cases, and two @entity2849 decreased in size. Intentional occlusion of the origin of left subclavian artery with the stent-graft in one @entity1 was tolerated without left arm or cerebral symptoms. One @entity1 experienced permanent @entity451 immediately after endovascular repair. There were no deaths during the hospital stay (range, 7-35 days; mean, 14.5 days). One @entity1 was lost to follow-up after hospital discharge. The clinical observation period for the remaining seven @entity1 was 38 to 99 weeks (mean, 60 weeks). CONCLUSIONS: Endovascular stent-graft repair in complicated penetrating @entity731 is an alternative therapeutic option to conventional thoracotomy, especially in @entity1 at high risk of increased morbidity and mortality perioperatively and postoperatively.
