Thorac Cardiovasc Surg 2008; 56 - MO28
DOI: 10.1055/s-2008-1037850

Mid-term results after endovascular stent-graft placement due to perforating atherosclerotic ulcers of the thoracic aorta

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

Aims: 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 cardiovascular events.

Methods: From 1997 through 2006, 27 patients (mean age 66yrs) presented with PAU (rupture n=7). Mean numeric EuroSCORE was 11 and mean logistic EuroSCORE was 35. Median follow-up was 42 (10–86) months, being complete in all patients. Outcome variables included death and occurence of early and late cardiovascular 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% respectively. Hemodynamic instability (OR 2.5; p=0.034) as well as logistic EuroSCORE (OR 2.8; p=0.019) were identified as independent predictors of early and late cardiovascular 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.