Korean J Radiol.  2012 Aug;13(4):476-482. 10.3348/kjr.2012.13.4.476.

Midterm Outcomes of Open Surgical Repair Compared with Thoracic Endovascular Repair for Isolated Descending Thoracic Aortic Disease

• Lee SH
• Chung CH
• Jung SH
• Lee JW
• Shin JH
• Ko KY
• Yoon HK
• Choo SJ

• KMID: 1383860
• DOI: http://doi.org/10.3348/kjr.2012.13.4.476

Abstract

OBJECTIVE
This study aimed to assess the surgical morbidity and mortality of thoracic endovascular repair (TEVAR) as compared with open surgical repair (OSR) for isolated descending thoracic aortic disease.
MATERIALS AND METHODS
From January 1, 2006 through May 31, 2010, a total of 68 patients with isolated descending thoracic aortic disease were retrospectively reviewed for the presence of perioperative complication, 30-day mortality, and clinical success. The patients were divided into two groups (group 1, OSR, n = 40 vs. group 2, TEVAR, n = 28) and these groups were compared for major variables and late outcomes.
RESULTS
The mean age was 58 years (group I = 54 vs. group II = 63 years, p = 0.011). Significant perioperative complications occurred in 12 patients: 8 (20%) in group I and 4 (13%) in group II (p = 0.3). There were five 30 day mortalities of which 4 occurred in group I and 1 in group II (p = 0.23). Clinical success (effective aortic remodeling and complete false lumen obliteration or thrombosis) was achieved in 20 patients (71%). Mean Kaplan-Meier survival rate at 1 year was similar for both groups (group 1 = 87% vs. group 2 = 80%, p = 0.65).
CONCLUSION
Thoracic endovascular repair for isolated thoracic aortic disease shows comparable results to OSR. However, the potential for endoleak or rupture remains a challenge that needs to be addressed in the future. Therefore, close follow-up study is needed for the evaluation of satisfactory long-term outcomes.

Keyword

Descending aorta disease; Thoracic endovascular repair; Open surgical repair

MeSH Terms

*Aorta, Thoracic
Aortic Diseases/mortality/*surgery
Chi-Square Distribution
Drainage
Endovascular Procedures/*methods
Female
Humans
Logistic Models
Magnetic Resonance Imaging
Male
Middle Aged
Postoperative Complications
Retrospective Studies
Risk Factors
Survival Rate
Thoracotomy
Treatment Outcome

Figure

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  Fig. 1 Disease categories. AD = aortic dissection, IMH = intramural hematoma, PAU = penetrating aortic ulceration

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  Fig. 2 Overall survival in all cohorts.

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