Outcomes of endovascular repair of ruptured descending thoracic aortic aneurysms

Frederik H W Jonker, Hence J M Verhagen, Peter H. Lin, Robin H. Heijmen, Santi Trimarchi, W. Anthony Lee, Frans L. Moll, Husam Athamneh, Bart E. Muhs

Research output: Contribution to journalArticle

Abstract

Background-: Thoracic endovascular aortic repair offers a less invasive approach for the treatment of ruptured descending thoracic aortic aneurysms (rDTAA). Due to the low incidence of this life-threatening condition, little is known about the outcomes of endovascular repair of rDTAA and the factors that affect these outcomes. Methods and Results-: We retrospectively investigated the outcomes of 87 patients who underwent thoracic endovascular aortic repair for rDTAA at 7 referral centers between 2002 and 2009. The mean age was 69.8±12 years and 69.0% of the patients were men. Hypovolemic shock was present in 21.8% of patients, and 40.2% were hemodynamically unstable. The 30-day mortality rate was 18.4%, and hypovolemic shock (odds ratio 4.75; 95% confidence interval, 1.37 to 16.5; P=0.014) and hemothorax at admission (odds ratio 6.65; 95% confidence interval, 1.64 to 27.1; P=0.008) were associated with increased 30-day mortality after adjusting for age. Stroke and paraplegia occurred each in 8.0%, and endoleak was diagnosed in 18.4% of patients within the first 30 days after thoracic endovascular aortic repair. Four additional patients died as a result of procedure-related complications during a median follow-up of 13 months; the estimated aneurysm-related mortality at 4 years was 25.4%. Conclusion-: Endovascular repair of rDTAA is associated with encouraging results. The endovascular approach was associated with considerable rates of neurological complications and procedure-related complications such as endoleak.

Original languageEnglish
Pages (from-to)2718-2723
Number of pages6
JournalCirculation
Volume121
Issue number25
DOIs
Publication statusPublished - Jun 29 2010

Keywords

  • aneurysm
  • aorta
  • surgery
  • survival

ASJC Scopus subject areas

  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine

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    Jonker, F. H. W., Verhagen, H. J. M., Lin, P. H., Heijmen, R. H., Trimarchi, S., Lee, W. A., Moll, F. L., Athamneh, H., & Muhs, B. E. (2010). Outcomes of endovascular repair of ruptured descending thoracic aortic aneurysms. Circulation, 121(25), 2718-2723. https://doi.org/10.1161/CIRCULATIONAHA.109.908871