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DOI: 10.1055/s-0030-1269217
Serious complications following endovascular treatment of thoracic aortic disease –10 years experience
Introduction: With growing experience in aortic endovascular stent-graft repair more and more complications are reported. We describe serious complications following endovascular treatment of thoracic aortic disease.
Methods: Between 2000 and 2010, 138 patients (49 women; mean age 65 years, range 19 to 89 years) with aortic disease (79 thoracic aortic aneurysm, 53 type B aortic dissection, 6 others) underwent endovascular repair. Twenty two patients required emergency treatment. The mean follow-up period was 15 months (range, 1 to 94 months). Before discharge and on follow-up visits, imaging of the aorta was performed using computed tomography.
Results: Conversion to an open procedure was performed in 3 patients. Complications with indication for a secondary consecutive reintervention occurred in 13.8% (19/138) of patients. Indications included stent dislocation, incomplete stent expansion, endoleaks and new incidence of aortic dissection. Retrograde type A dissection occurred in 2 patients. Eight of 138 patients (5.8%) received additional vascular surgery due to iliac artery rupture or postinterventional limb ischemia. One patient developed aortoesophageal fistula. Spinal cord injury was a postoperative complication in 3.6% (5/138) of patients. Thirty-day mortality was 2.2% (3/138). Mid-term survival was 86.2%.
Conclusions: In this institutional series, mid-term results after stent-graft repair of thoracic aortic disease are good, however not without serious complications. Long-term experience and further evolution of endovascular device will reduce the complication rate of endovascular therapy.