Endovascular repair of thoracic aortic aneurysms: a paradigm shift in standard of care.

The standard open surgical treatment of thoracic aortic aneurysms is associated with significant morbidity and mortality. Endovascular repair is less invasive and potentially less morbid for patients with multiple risk factors. The authors report their results in 9 consecutive high-risk patients treated with endovascular grafts from January 1998 through June 2000. There were 7 men and 2 women patients with an average age of 75 years. Mean aneurysm diameter was 7.1 cm. All aneurysms were repaired with Gianturco Z-stent polytetrafluoroethylene prostheses. There were no perioperative deaths. Mean length of stay was 6.3 days. Technical success was achieved in all 9 patients. Two patients had neurologic complications following repair (1 patient with transient lower extremity numbness related to spinal arthritis and 1 patient with bowel and bladder incontinence). Both patients were independent with ambulation. Mean follow-up was 15.8 months. There was no evidence of endoleak or stent migration during the follow-up period. These findings support endovascular treatment of high-risk patients with thoracic aneurysm.