Early Results of Endovascular Treatment of the Thoracic Aorta Using the Valiant Endograft

Journal Article · Thu Nov 15 04:00:00 EST 2007 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-007-9147-X· OSTI ID:21090738

Thompson, Matt; Ivaz, Stella ^[1]; Cheshire, Nicholas ^[2]; Fattori, Rosella ^[3]; Rousseau, Herve ^[4]; Heijmen, Robin ^[5]; Beregi, Jean-Paul ^[6]; Thony, Frederic ^[7]; Horne, Gillian; Morgan, Robert; Loftus, Ian ^[1]

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1. 4th Floor St James Wing, St George's Hospital NHS Trust, St George's Vascular Institute (United Kingdom)
2. St Mary's Regional Vascular Unit (United Kingdom)
3. University Hospital, Department of Cardiovascular Radiology (Italy)
4. Centre Hospitalier Universitaire, Department of Radiology (France)
5. St Antonius Hospital, Department of Cardiothoracic Surgery (Netherlands)
6. Hopital Cardiologique, Department of Vascular Radiology (France)
7. Hospitalier Universitaire de Grenoble, Service de Radiologie Centre (France)

Endovascular repair of the thoracic aorta has been adopted as the first-line therapy for much pathology. Initial results from the early-generation endografts have highlighted the potential of this technique. Newer-generation endografts have now been introduced into clinical practice and careful assessment of their performance should be mandatory. This study describes the initial experience with the Valiant endograft and makes comparisons with similar series documenting previous-generation endografts. Data were retrospectively collected on 180 patients treated with the Valiant endograft at seven European centers between March 2005 and October 2006. The patient cohort consisted of 66 patients with thoracic aneurysms, 22 with thoracoabdominal aneurysms, 19 with an acute aortic syndrome, 52 with aneurysmal degeneration of a chronic dissection, and 21 patients with traumatic aortic transection. The overall 30-day mortality for the series was 7.2%, with a stroke rate of 3.8% and a paraplegia rate of 3.3%. Subgroup analysis demonstrated that mortality differed significantly between different indications; thoracic aneurysms (6.1%), thoracoabdominal aneurysms (27.3%), acute aortic syndrome (10.5%), chronic dissections (1.9%), and acute transections (0%). Adjunctive surgical procedures were required in 63 patients, and 51% of patients had grafts deployed proximal to the left subclavian artery. Comparison with a series of earlier-generation grafts demonstrated a significant increase in complexity of procedure as assessed by graft implantation site, number of grafts and patient comorbidity. The data demonstrate acceptable results for a new-generation endograft in series of patients with diverse thoracic aortic pathology. Comparison of clinical outcomes between different endografts poses considerable challenges due to differing case complexity.

• OSTI ID: 21090738
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 6 Vol. 30; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
AORTA
CHARGES
GRAFTS
MORTALITY
PATHOLOGY
PATIENTS
SURGERY
THERAPY