Endograft repair for pseudoaneurysms and penetrating ulcers of the ascending aorta

Gabriele Piffaretti, Mario Galli, Chiara Lomazzi, Marco Franchin, Patrizio Castelli, Giovanni Mariscalco, Santi Trimarchi

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Objective: The aim of this paper is to report midterm results of thoracic endovascular aortic repair (TEVAR) for ascending aortic pseudoaneurysms (AAPs) and penetrating aortic ulcers (PAUs) of the ascending aorta. Methods: This study was retrospective and performed at tertiary centers. Eight patients with AAPs (n = 5) and PAUs (n = 3) received total endovascular repair of the ascending aorta. Patients with a history of type A aortic dissection or fusiform aneurysm were excluded. All patients analyzed were considered to be at high risk for open repair at the time of presentation. Results: Urgent intervention was performed in 6 (75%) cases. Primary clinical success was achieved in 7 (87.5%) cases. A low-flow type 3 endoleak remained asymptomatic and was managed conservatively. No TEVAR-related in-hospital mortality, primary conversion, cerebrovascular accidents, valve impairment, or myocardial infarction occurred. All patients were discharged home, alive and independent, after a median length of stay of 6 (range: 5-24) days. No patient was lost at a mean follow-up of 40 ± 33 (range: 4-93) months. Ongoing primary clinical success was maintained in all but 1 patient (type 3 endoleak): aortically related reintervention was never required. No endograft breakage or migration was observed. At 1-year follow-up, 7 (87.5%) aortic lesions had significant reduction in diameter (≥5 mm). Conclusions: Ascending TEVAR was feasible, safe, and effective for AAPs and PAUs. In a very select subset of lesions, midterm results were favorable, with both standard and custom-designed endografts.

Original languageEnglish
JournalJournal of Thoracic and Cardiovascular Surgery
DOIs
Publication statusAccepted/In press - Jul 28 2015

Fingerprint

False Aneurysm
Ulcer
Aorta
Endoleak
Thorax
Aortic Aneurysm
Hospital Mortality
Aneurysm
Dissection
Length of Stay
Retrospective Studies
Stroke
Myocardial Infarction

Keywords

  • Ascending aortic pseudoaneurysm
  • Penetrating ulcer
  • Thoracic endovascular aortic repair

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Cite this

Piffaretti, G., Galli, M., Lomazzi, C., Franchin, M., Castelli, P., Mariscalco, G., & Trimarchi, S. (Accepted/In press). Endograft repair for pseudoaneurysms and penetrating ulcers of the ascending aorta. Journal of Thoracic and Cardiovascular Surgery. https://doi.org/10.1016/j.jtcvs.2015.12.055

Endograft repair for pseudoaneurysms and penetrating ulcers of the ascending aorta. / Piffaretti, Gabriele; Galli, Mario; Lomazzi, Chiara; Franchin, Marco; Castelli, Patrizio; Mariscalco, Giovanni; Trimarchi, Santi.

In: Journal of Thoracic and Cardiovascular Surgery, 28.07.2015.

Research output: Contribution to journalArticle

Piffaretti, Gabriele ; Galli, Mario ; Lomazzi, Chiara ; Franchin, Marco ; Castelli, Patrizio ; Mariscalco, Giovanni ; Trimarchi, Santi. / Endograft repair for pseudoaneurysms and penetrating ulcers of the ascending aorta. In: Journal of Thoracic and Cardiovascular Surgery. 2015.
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