• Vol. 40 No. 9, 414–417
  • 15 September 2011

Thoracic Endovascular Aortic Repair: A Local Single Institution Experience

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ABSTRACT

Introduction: The purpose of this retrospective study was to evaluate the short- to mid-term results of the endovascular repair of thoracic aortic disease and to present an overview of our experience with thoracic endovascular aortic repair (TEVAR) in our institution.

Materials and Methods: A retrospective review of all patients who were treated and underwent TEVAR in our institution between August 2004 and November 2009 was conducted.

Results: Technical success was achieved in 100% of the patients and the 30-day mortality rate was 0%. Perioperative endoleak was visualised at the end of the procedure in 4 patients. Secondary endoleak was observed in 2 patients. Mean hospital length of stay post-TEVAR was 15.4 days. Postoperative major complications were observed in 4 patients. The 30-day mortality rate was 0%, with 2 mortalities (11.1%) during the follow-up period.

Conclusion: This study adds to the growing body of literature that support TEVAR as an effective procedure in the management of thoracic aortic diseases and reflects its feasibility in our population. Further technical advancement in stent grafts, careful selection of patients and standardised peri-procedural care would contribute to further improvements in clinical outcomes.


Diseases involving the thoracic aorta are often associated with high mortality due to the thoracic aorta’s propensity to rupture. They include aneurysms, dissections, traumatic pseudoaneurysms, intramural haematomas and penetrating atherosclerotic ulcers. Traditional management comprises optimising medical therapy, in particular, the control of hypertension in conjunction with surgical repair. However, even with remarkable technical advances and improved prosthetic grafts, the surgical mortality rate is 5% to 15% under elective conditions in experienced centers, and the mortality rate under emergency conditions is even more dismal, with a mortality rate in excess of 50%. The high mortality rate is, in part, due to the population affected, who are usually elderly and often have poor premorbid function, which makes them poor surgical candidates, if at all suitable. Thoracic endovascular aortic repair (TEVAR) is an endovascular technique that offers an attractive and promising alternative to open surgical repair, particularly in this subset of patient group.

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