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Stent-graft implantation in patients with thoracic aneurysm
Autorzy: Magdalena Filip, Weronika Oleśkowska-Florek
Modern radiological examinations facilitate recognizing and compressing of aortic lesions. Symptoms of developing thoracic aorta disorders could be highly atypical. The aim of the study was to present our experience in the endovascular treatment of thoracic descending aorta disorders.

Material and methods:
We examined 23 consecutive patients (pts) (17 men, 6 women) at the mean age of 62,63 +/- 11,63 years who underwent endovascular treatment of thoracic aorta disorders. The Zenith stent-graft was implemented to the thoracic part of the descending aorta. Clinical indication to perform procedures were as follows: Type A (according to Stanford’s classification) dissection in 2 pts, type B - 19 pts, pseudoaneurysm - 1 pts, aortic
intramural hematoma (AIH) - 1 pts. The operating team was consisted of: 2 cardiosurgeons, radiologist and an anesthetist. Before introduction of the prosthesis, 5000 U of heparin was given intravenously. During stent-graft implantation general anesthesia was used as a standard. The endovascular procedure was preceded by angio-
CT examination. 6 months after treatment control angio-CT was done.

14 pts were admitted in case of emergency, 9 pts admitted according the plan. There were 3 pts with history of myocardial infarction, 5 pts with history of ischaemic heart disease, and 2 pts with diabetes mellitus. The mean stent-graft diameter amounted to 36,90 mm ± 3,75 and 179,13 ± 31,85 mm length. Because of length of aorta aneurysm, 7 pts had more than 1 stent-graft implanted. Increase of temperature to 38,0o C during postoperative
course was observed in 12 pts. The mean time of the operation was 1h 30 min (±11 min). During the postoperative period 1 patient had ischaemia of the left kidney, 2 pts had neurological incidents. 2 patients died (1 patient in short period of time after the operation, 1patient 4 months after endovascular procedure) because of aortic thoracic disorders, 1 patient died for non-cardiac cause.

The endovascular treatment was a breakthrough of cardiosurgery. Advantages of endovascular treatment are: lower risk of serious complications (especially complications of respiratory and circulatory system), a shorter time of hospitalization and smaller loss of blood than in the classical procedures. The cost of this procedure could be disadvantage of this treatment. Endovascular techniques were performed in patients whose poor general condition rendered impossible surgical intervention. Intravascular aortic aneurysm reatment is a particularly good solution and it may be recomended, as a safe treatment method of choice in thoracic aortic aneurysms. Complications following endovascular treatment are rare.
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