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.