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Endovascular Repair versus Open Repair for Isolated Descending Thoracic Aortic Aneurysm

 Hyung Chae Lee  ;  Hyun-Chel Joo  ;  Seung Hyun Lee  ;  Sak Lee  ;  Byung-Chul Chang  ;  Kyung-Jong Yoo  ;  Young-Nam Youn 
 Yonsei Medical Journal, Vol.56(4) : 904-912, 2015 
Journal Title
 Yonsei Medical Journal 
Issue Date
Age Factors ; Aged ; Aneurysm, Dissecting/epidemiology* ; Aneurysm, Dissecting/surgery ; Aortic Aneurysm, Thoracic/mortality ; Aortic Aneurysm, Thoracic/surgery* ; Aortic Rupture/mortality ; Aortic Rupture/surgery* ; Blood Vessel Prosthesis Implantation ; Endovascular Procedures ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Republic of Korea ; Stroke/etiology ; Survival Rate ; Time Factors ; Treatment Outcome
Aortic aneurysm ; aorta ; cardiovascular surgical procedures ; descending ; endovascular procedures ; outcome assessment
PURPOSE: To compare the outcomes of thoracic endovascular aortic repair (TEVAR) with those of open repair for descending thoracic aortic aneurysms (DTAA). MATERIALS AND METHODS: We compared the outcomes of 114 patients with DTAA and proximal landing zones 3 or 4 after TEVAR to those of 53 patients after conventional open repairs. Thirty-day and late mortality were the primary endpoints, and early morbidities, aneurysm-related death, and re-intervention were the secondary endpoints. RESULTS: The TEVAR group was older and had more incidences of dissecting aneurysm. The mean follow-up was 36±26 months (follow-up rate, 97.8%). The 30-day mortality in the TEVAR and open repair groups were 3.5% and 9.4% (p=0.11). Perioperative stroke and paraplegia incidences were similar between the groups [5.3% vs. 7.5% (p=0.56) and 7.5% vs. 3.5% (p=0.26), respectively]. Respiratory failure occurred more in the open repair group (1.8% vs. 26.4%, p<0.01). The incidence of acute kidney injury requiring dialysis was higher in the open repair group (1.8% vs. 9.4%, p<0.01). The cumulative survival rate was higher in the TEVAR group at 2 to 5 years (79.6% vs. 58.3%, p=0.03). The free from re-intervention was lower in the TEVAR group (65.3% vs. 100%, p=0.02), and the free from aneurysm-related death in the TEVAR and open repair groups were 88.5% and 86.1% (p=0.45). CONCLUSION: TEVAR is safe and effective for treating DTAAs with improved perioperative and long-term outcomes compared with open repair.
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1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Yoo, Kyung Jong(유경종) ORCID logo https://orcid.org/0000-0002-9858-140X
Youn, Young Nam(윤영남)
Lee, Sak(이삭) ORCID logo https://orcid.org/0000-0001-6130-2342
Lee, Seung Hyun(이승현) ORCID logo https://orcid.org/0000-0002-0311-6565
Chang, Byung Chul(장병철)
Joo, Hyun Chel(주현철) ORCID logo https://orcid.org/0000-0002-6842-2942
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