Graft-Stent Preferred for Thoracic Aorta Repair

A new study has shown that stent-graft repair of an injured or diseased thoracic aorta offered patients less risk of paraplegia as well as lower morbidity and mortality rates when compared to surgery.

Researchers at Guys Hospital (London, England) examined a prospective database from 1997 to 2006 that involved 190 patients (127 men and 63 women) who underwent nonsurgical thoracic aorta repair. All patients had diseased aortas in the thoracic area, such as degenerative aneurysm, dissections, ulcer, and other pathology. In total, 128 patients were treated electively and 62 underwent urgent repair. The stent-grafts were successfully deployed in 99.5% of the cases, and the incidence of death and permanent paralysis was only 1.6%. The study was presented at the Society of Interventional Radiology's 32nd annual scientific meeting, held during March 2007 in Seattle (WA, USA).

"Repairing a thoracic aorta should primarily be done with a stent-graft. Compared to surgery, the interventional treatment has a much lower risk of paralysis, less than 2% compared to open surgery which has approximately a 10% risk, even in the best of hands,” said lead author interventional radiologist John Reidy, M.D. "Placing a stent-graft is minimally invasive and much less traumatic for the patient. They avoid general anesthesia and have less problems with infection because there is no large chest incision.”

During surgical repair the patient is at increased risk of paraplegia because the thoracic aorta is clamped, cutting off blood to the spinal column. The interventional radiology treatment does not interrupt the blood supply since the endograft is advanced inside the artery, using imaging to guide it from the femoral artery in the groin to the precise location in the aorta where it is deployed, creating a new wall in the aorta from the inside.


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