Midterm results of endovascular stent graft treatment for descending aortic aneurysms including high-risk patients

Methods: 21 patients (17 men, 4 women; mean age 66.1 years, range 29-90 years) with 15 true aneurysms, and 6 type B-dissections were treated by implantation of a Talent(TM) Endoluminal Stentgraft System from February 2000 to July 2003. In 3 cases it was necessary to overstent the left subclavian artery, in 1 case to overstent the left common carotid. Results: 2 patients (9.5%) died during the first 30 days (1 myocardial infarction, 1 pneumonia). Two patients (9.5%) suffered from cerebral ischemia and needed revascularisation. No paraplegia, no stroke occurred. One endoleak required additional stenting. No patient needed conversion. Follow-up, average 25.4 months (range 0-39), was 100% complete. During this another two patients died of myocardial infarction i.e. 9.5% (the above mentioned endoleak, but no late migration were detected in the remaining patients). In all cases the graft lumen stayed patent. Conclusions: Treatment of descending thoracic aortic aneurysm with an endovascular approach has acceptable mortality and morbidity-rates even in high risk patients. Procedural overstenting of the subclavian artery requires subclavian revascularisation in a minority of cases.