[TEVAR: a strategy for the diversity of thoracic aorta disease. Series of cases and national prospect].

OBJECTIVE

To assess endovascular treatment of thoracic aorta diseases in a national centre of angiology and vascular surgery. To quantify the national registry of TEVAR's.

MATERIAL AND

METHODS

This unicentric and retrospective study included patients submitted to TEVAR until the end of 2012. Twenty-seven patients were considered high-risk for conventional surgery: 14 degenerative thoracic aorta aneurysms or pseudoaneurysms (10 assymptomatic), 1 ruptured thoracoabdominal aneurysm, 5 aortabronchial/aortoesophageal fistulas, 3 complicated dissections, 2 penetrating atherosclerotic ulcer/intramural hematoma, 1 traumatic laceration and 1 embolization from aortic plaque. Eighteen (67%) were emergent/urgent procedures.

RESULTS

At the institutional level, immediate technical success was achieved in all cases; average follow up was 24 months (0-97). Thirty days and 24 months global mortality was, respectively, 4% (6% for emergent/urgent procedures and 0% for elective procedures) and 13%. Aortic-related mortality was similar. One case of paraplegia and 2 of case of stoke were registered. Endoleak was present in 4 patients. Survival free from aneurysmal sac expansion (aneurysm, pseudoaneurysm or dissection, n=16) was 88% at 30 days. Survival free from aortic reintervention was 93% at 30 days and 81% at 24 months. Nationally, TEVAR registries triplicated from 2007 top 2010.

CONCLUSION

These results favour the actual tendency to consider TEVAR as a first-line solution for several thoracic aortic diseases.