This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS

Thoracic aortic stent grafts. BJS 2000; 87: 492-493.

Published: 6th December 2002

Authors: P. R. Taylor, C. L. McGuinness, J. F. Reidy

Background

Open surgical intervention for aneurysms of the distal arch and descending thoracic aorta is associated with high morbidity and mortality rates. Stent grafts offer an attractive alternative treatment for these aneurysms.

Method

Thirteen patients were treated from July 1997 to August 1999. Eight patients had atheromatous aneurysms; five were elective and three urgent for dysphagia, stridor and back pain. The mean age of these patients was 77 (range 64–90) years. Another five urgent cases comprised transection (two), traumatic dissection (one), acute dissection (one) and secondary aorto‐oesophageal fistula (one). The mean age of these patients was 43 (range 18–77) years. The types of stent graft used were Excluder (six), AneuRx (five), Vanguard (one) and Stenford (one). Additional surgical procedures included carotid‐to‐carotid bypass, exposure of the common iliac artery (as the device was too short to reach the proximal descending thoracic aorta) and repair of a symptomatic infrarenal aortic aneurysm.

Results

One patient with acute aortic dissection 1 month after myocardial infarction died from pulmonary embolus and myocardial reinfarction (mortality rate 8 per cent). One patient who suffered a stroke with good recovery was discharged on day 21 but died from pneumonia at 8 weeks. All aneurysms were excluded on computed tomography apart from the traumatic dissection in which perfusion of the false lumen continued retrogradely. No patient suffered paraplegia or renal failure. No ward patient required admission to the intensive care unit.

Conclusion

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