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  • Title: Early and long-term results of replacement of the descending aorta.
    Author: Brandt M, Hussel K, Walluscheck KP, Böning A, Rahimi A, Cremer J.
    Journal: Eur J Vasc Endovasc Surg; 2005 Oct; 30(4):365-9. PubMed ID: 15890547.
    Abstract:
    OBJECTIVES: The aim of this analysis was to evaluate our results of open surgery on the descending thoracic aorta as benchmark to define indications for endovascular treatment. METHODS: Between January 1981 and December 2000, 115 patients underwent replacement of the descending or thoraco-abdominal aorta. Follow-up to 20 years was complete in 98%. RESULTS: Early mortality was 19% and paraplegia rate was 7%. Surgery before 1990 and coronary artery disease were independent predictors for early mortality. Thoraco-abdominal repair and normothermia were independent predictors for paraplegia. Ten years survival rate was 63%. CONCLUSIONS: Our results confirm that replacement of the descending aorta can be performed today with acceptable low mortality and morbidity and with consistent exclusion of the aneurysm or dissection. Long-term results of endovascular stent-grafts in the descending aorta are unclear. In our opinion endovascular stent-grafts should be reserved for high risk patients, acute dissection or acute aortic rupture.
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