Abstract 3829: Twelve Years’ Experience of Aortic Stent Graft Implantation: Mortality and Clinical Outcome
Background: Endoluminal stent-graft repair for aortic aneurysm or dissection replaced some part of surgical correction because of its higher success rate with less invasiveness and mortality. Aortic stent graft was performed at the various aortoiliac pathology for the last 12 years. The object of study is to assess long-term mortality and clinical results of the endoluminal therapy for patients with aortoiliac pathology.
Methods: A retrospective analysis was done on 166 pts (62.7±12.0) who underwent stent-graft repair at our single center from September, 1994 to April, 2006. The indications were progression of aortic pathology despite adequate medical treatment, dynamic obstruction, aggravation of pain, or other medically intractable complications in either acute or chronic presentation.
Results: Median follow-up duration was 3.8 years (2 mon~12 yrs, 3.8 ± 3.2 yrs). Clinical diagnoses were aortic aneurysm (109 pts, 57.7%), aortic dissection (40 pts, 21.2%), ruptured aorta (6 pts, 2.6%), and others (11 pts, 5.8%). Locations of each lesion were abdominoiliac vessel (32.8%), thoracic aorta (28.6%), abdominal aorta (21.2%), and others (5.2%). Angiographic success, defined as immediate obliteration of target lesion without major endoleak or complete exclusion of aneurysm, was obtained in 101/109 (92.7%) of aortic aneurysm, and 39/40 (97.5%) of aortic dissection. Clinical success, defined as complete obliteration of the target lesion at follow-up without further interventional or operative management, was achieved in 89/109 (81.7%) of aortic aneurysm, and 34/40 (85%) of aortic dissection. Among these patients, 15 pts were expired due to multiorgan failure (3.2%), heart failure (3.2%), and renal failure (1.1%). Co-morbidities include coronary artery disease requiring intervention (16.4%), connective tissue disease including Marfan syndrome or Behçet disease (2.1%), and others (1%).
Conclusions: The outcome of endovascular stent-graft repair of aortic disease was acceptable with a clinical success rate of 74.1% without acute procedure-associated mortality. Endolu-minal stent-graft repair should be considered as a safe and effective alternative treatment option of aortic pathology particularly in pts with a high risk of surgical mortality.