Thorac Cardiovasc Surg 2007; 55 - MP_30
DOI: 10.1055/s-2007-967370

Mid-term results of patients after endovascular stent-graft placement due to perforating atherosclerotic ulcers

M Grimm 1, D Zimpfer 1, R Gottardi 1, M Schoder 2, J Lammer 2, M Dorfmeister 1, E Wolner 1, M Czerny 1
  • 1Medizinische Universität Wien, Herz-Thorax Chirurgie, Wien, Austria
  • 2Medizinische Universität Wien, Interventionelle Radiologie, Wien, Austria

Objectives: To determine mid-term durability of endovascular stent-graft placement in patients with perforating atherosclerotic ulcers (PAU) involving the thoracic aorta and to identify risk factors for death as well as early and late adverse events.

Methods: From 1997 through 2006, 27 patients (mean age 66yrs) presented with PAU, seven patients had rupture. Seventy-eight percent were unsuitable for conventional repair. Mean numeric EuroSCORE was 11 and mean logistic EuroSCORE was 35. Median follow-up was 35 (2–86) months, being complete in all patients. Outcome variables included death and occurrence of early and late adverse events.

Results: In-hospital mortality was 11%. Primary success rate was 100%. Actuarial survival rates at 1, 3 and 5 years were 93%, 78% and 70% and actuarial event-free survival rates were 89%, 74% and 62% respectively. Hemodynamic instability as well as logistic EuroSCORE were identified as independent predictos of early and late adverse events.

Conclusions: Endovascular stent-graft placement in patients with PAU is an effective palliation for a life-threatening sign of a severe systemic process. Hemodynamic instability at referral and a high preoperative risk score predict adverse outcome. During mid-term follow-up, patients are mainly limited by sequelae of their underlying disease.