Transluminal placement of endovascular stent-grafts for the treatment of descending thoracic aortic aneurysms

Dake, Michael D., Miller, D. Craig, Semba, Charles P., Mitchell, R. Scott, Walker, Philip J. and Liddell, Robert P. (1994) Transluminal placement of endovascular stent-grafts for the treatment of descending thoracic aortic aneurysms. New England Journal of Medicine, 331 26: 1729-1734. doi:10.1056/NEJM199412293312601


Author Dake, Michael D.
Miller, D. Craig
Semba, Charles P.
Mitchell, R. Scott
Walker, Philip J.
Liddell, Robert P.
Title Transluminal placement of endovascular stent-grafts for the treatment of descending thoracic aortic aneurysms
Journal name New England Journal of Medicine   Check publisher's open access policy
ISSN 0028-4793
1533-4406
Publication date 1994-12
Sub-type Article (original research)
DOI 10.1056/NEJM199412293312601
Volume 331
Issue 26
Start page 1729
End page 1734
Total pages 6
Place of publication Boston, MA, United States
Publisher Massachusetts Medical Society
Language eng
Formatted abstract
Background. The usual treatment for thoracic aortic aneurysms is surgical replacement with a prosthetic graft, but the associated morbidity and mortality are considerable. We studied the use of transluminally placed endovascular stent-graft devices as an alternative to surgical repair.

Methods. We evaluated the feasibility, safety, and effectiveness of transluminally placed stent-grafts to treat descending thoracic aortic aneurysms in 13 patients over a 24-month period. Atherosclerotic, anastomotic, and post-traumatic true or false aneurysms and aortic dissections were treated. The mean diameter of the aneurysms was 6.1 cm (range, 5 to 8). The endovascular stent-grafts were custom-designed for each patient and were constructed of self-expanding stainless-steel stents covered with woven Dacron grafts.

Results. Endovascular placement of the stent-graft prosthesis was successful in all patients. There was complete thrombosis of the thoracic aortic aneurysm surrounding the stent-graft in 12 patients, and partial thrombosis in 1. Two patients initially had small, residual patent proximal tracts into the aneurysm sac, but both tracts thrombosed within two months after the procedure. In four patients, two prostheses were required to bridge the aneurysm adequately. There have been no deaths or instances of paraplegia, stroke, distal embolization, or infection during an average follow-up of 11.6 months. One patient with an extensive chronic aortic dissection required open surgical graft replacement four months later because of progressive dilatation of the arch.

Conclusions. These preliminary results demonstrate that endovascular stent-graft repair is safe in highly selected patients with descending thoracic aortic aneurysms. This new method of treatment will, however, require careful long-term evaluation.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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