Stent-grafting of the thoracic aorta by the cardiothoracic surgeon

Endovascular Treatment of Patients With Types A and B Thoracic Aortic Dissection Using Relay Thoracic Stent-Grafts: Results From the RESTORE Patient Registry

“…The rationale behind TEVAR use in aortic dissections is to obliterate the false lumen and restore the normal aortic anatomy in order to prevent aortic expansion and/or rupture. In our study, the 95% technical success rate (98% in acute and 93% in type B dissections) compared well with several studies involving larger populations of patients, 11 including a single-center study that involved first- and second-generation stent-grafts 21 and the more recent Talent Thoracic Retrospective Registry, 22 all of which reported success rates of 92% to 98%. Moreover, our results improve upon the 89% and 78% technical success rates in acute and chronic type B dissections, respectively, reported by Guangqi et al 23 and also those achieved in EUROSTAR (European Collaborators on Stent-Graft Techniques for Aortic Aneurysm Repair) and the UK Thoracic Endograft Registry, 9 in which technical success was achieved in 89% of patients.…”

Thoracic Aortic Endograft Explant: A Single-Center Experience

“…The patients treated more electively with delayed conversion were all discharged home. 15 This echoes our finding that immediate intraoperative conversion to open endograft explantation and repair portends worse outcome, as the perioperative mortality in our study was a patient who required immediate conversion.…”

“…In this series, delayed open conversion of failed TEVAR took place prior to hospital discharge; these cases were the result of additional access problems as well as bare spring penetration into the aortic wall. 15 Of the 3 patients who were immediately converted to open endograft explantation and repair, 1 died, 1 had an extended hospital stay for severe neurologic deficit, and 1 patient was successfully discharged. The patients treated more electively with delayed conversion were all discharged home.…”

Biomechanical Changes After Thoracic Endovascular Aortic Repair in Type B Dissection

“…130 Other reported indications for stent-graft explantation include deployment-related problems, stent-graft infection, migration, collapse, kinking, aortic rupture, and fracture. 39,124,131,132 In the presence of highly unstable hemodynamic conditions, TEVAR has also been proposed as a bridge to open surgery. 133…”