Thoracic endovascular aortic repair of penetrating thoracic aortic ulcer: analysis of 7 cases and literature review

• Main Authors: ZHANG Rongjie, SUN Long, SUN Wei, HU Chunfang, HAO Yingxue
• Format: Article
• Language: zho
• Published: Editorial Office of Journal of Third Military Medical University 2019-12-01
• Series: Di-san junyi daxue xuebao
• Subjects: thoracic penetrating aortic ulcer; thoracic endovascular aortic repair; endovascular surgery; minimally invasive surgery
• Online Access: http://aammt.tmmu.edu.cn/Upload/rhtml/201906091.htm

Objective To investigate the indications, therapeutic effects and safety of thoracic endovascular aortic repair for treatment of thoracic penetrating aortic ulcer. Methods We retrospectively analyzed clinical data of the patients diagnosed with penetrating thoracic aortic ulcer, who underwent thoracic endovascular aortic repair in our department between October, 2018 and May, 2019. The patients' age, lesion location and type, comorbidities, surgical methods, operation time, intraoperative blood loss, length of hospital stay, perioperative complications and follow-up data were analyzed. Results We analyzed the clinical data for 7 patients with a mean age of 70.29±7.54 years, including 3 patients with penetrating ulcers in the aortic arch and 4 with ulcers in the descending thoracic aorta. The mean depth of the penetrating aortic ulcers was 6.00±2.02 mm with a mean width of 12.07±5.26 mm and a mean length of 14.71±9.05 mm. The opration were completed smoothly in all the patients with a mean operation time of 90.00±32.53 min. A chimney stent was placed in the left subclavian artery in 3 cases. The patients were followed up for 1 to 7 months, during which the penetrating thoracic aortic ulcers were found to be effectively repaired in all the cases; endoleaks of any types or other complications occurred in none of the cases during the follow-up. Conclusion Thoracic endovascular aortic repair is safe and effective for treatment of penetrating thoracic aortic ulcer, and can be safely performed in elderly patients and patients with comorbidities.