Ulus Travma Acil Cerrahi Derg. 2008; 14(3): 192-200

Endovascular therapy for thoracic and abdominal aortic emergencies

Erdal Aslým¹, Tankut Hakký Akay¹, Süleyman Özkan¹, Ali Harman^2
1Baskent University, Faculty Of Medicine, Department Of Cardiovascular Surgery, Ankara, Turkey
²Baskent University, Faculty Of Medicine, Department Of Radiology, Ankara, Turkey

BACKGROUND: Emergent situations of both the thoracic and abdominal aortae are serious life-threatening situations. Endovascular stent graft repair offers an alternative to conventional operation for management of aortic diseases. Our aim was to report our experience with endovascular stent graft repair of thoracic and abdominal aortic emergencies. METHODS: Between April 2004 and March 2007, endovascular stent graft repair was performed in 16 patients (13 males, 3 females; mean age 61.4±16.3; range 38 to 86 years). The emergent lesions were in the thoracic aorta in 8 patients and abdominal aorta in the remainder. The deployed stent graft systems were Talent-Medtronic (n=8) and Excluder-Gore (n=8). RESULTS: Successful deployment of the stent grafts in the appropriate position was achieved in all patients. Hospital mortality occurred in 3 patients. There was no conversion to open surgery. The total number of endoleaks was 3 (18.75%). CONCLUSION: Endovascular stent graft placement is a feasible and effective approach in the emergency treatment of patients with complicated emergent pathologies of both thoracic and abdominal aortae.

Keywords: Aortic aneurysm, abdominal/surgery, aortic emergencies; endovascular therapy; stents; morbidity.

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Torakal ve abdominal aortanýn acil patolojilerinde endovasküler tedavi

Erdal Aslým¹, Tankut Hakký Akay¹, Süleyman Özkan¹, Ali Harman^2
1Baþkent Üniversitesi, Týp Fakültesi Kalp Ve Damar Cerrahisi
²Baþkent Üniversitesi, Týp Fakültesi Radyoloji Bölümü

AMAÇ: Torakal ve abdominal aortanýn anevrizma rüptürü ve diseksiyon gibi acil patolojileri önemli derecede yaþamý tehdit ederler. Aortanýn acil giriþim gerektiren bu patolojilerinde endovasküler tedaviler konvansiyonel cerrahiye bir alternatif teþkil etmektedir. Çalýþmada, endovasküler tedavilerin aortanýn acil patolojilerindeki uygulanabilirliði araþtýrýldý. GEREÇ-YÖNTEM: Nisan 2004 ile Mart 2007 tarihleri arasýnda 16 hastaya (13 erkek, 3 kadýn; ort. yaþ 61,4±16,3; daðýlým 38-86) acil olarak endovasküler yolla stent greft implantasyonu uygulandý. Lezyonlarýn sekizi torakal, sekizi abdominal aortada idi. Sekiz hastaya Gore Excluder Endoprosthesis, sekiz hastaya MedtronicVascular Talent Endoluminal Graft System kullanýldý. BULGULAR: Tüm hastalara implantasyon baþarý ile uygulandý, hiçbir hastada açýk cerrahiye dönüþüme ihtiyaç duyulmadý. Hastane mortalitesi üç hasta olarak gerçekleþti, üç hastada (%18,75) endoleak ile karþýlaþýldý. SONUÇ: Anevrizma ya da diseksiyon gibi acil giriþim gerektiren aort patolojilerinde ameliyat öncesi ve sonrasý morbidite ve mortalitenin düþük olmasý nedeniyle endovasküler stent implantasyonu efektif ve teknik olarak uygulanabilirliði yüksek olan bir yöntemdir.

Anahtar Kelimeler: Aortik anevrizma, abdominal/cerrahi, aortik acil patolojiler; endovasküler tedavi; stent; morbidite.

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