The “first generation” of endovascular stent-grafts for patients with aneurysms of the descending thoracic aorta Michael D. Dake, MD, D.Craig Miller,

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Presentation transcript:

The “first generation” of endovascular stent-grafts for patients with aneurysms of the descending thoracic aorta Michael D. Dake, MD, D.Craig Miller, MD, R.Scott Mitchell, MD, Charles P. Semba, MD, Kathleen A. Moore, BS, Toyohiko Sakai, MD The Journal of Thoracic and Cardiovascular Surgery Volume 116, Issue 5, Pages 689-704 (November 1998) DOI: 10.1016/S0022-5223(98)00455-3 Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig 1 Histogram illustrating the number of endovascular stent-grafts carried out per year to repair descending thoracic aortic aneurysms. Also shown, for perspective, is the number of conventional open surgical graft replacement procedures each year for patients with descending thoracic aortic aneurysms on our service. S-G, Stent-graft. The Journal of Thoracic and Cardiovascular Surgery 1998 116, 689-704DOI: (10.1016/S0022-5223(98)00455-3) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig 2 A, Actuarial curve depicting overall survival estimates for all 103 patients. B, Survival estimates according to whether the patient was judged not to be a reasonable candidate for open repair. SE, Standard error of the estimate. The Journal of Thoracic and Cardiovascular Surgery 1998 116, 689-704DOI: (10.1016/S0022-5223(98)00455-3) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig 3 Actuarial estimate of the freedom from treatment failure 2 (see text for definition) for all 103 patients. SE, Standard error of the estimate; TF#2, treatment failure 2. The Journal of Thoracic and Cardiovascular Surgery 1998 116, 689-704DOI: (10.1016/S0022-5223(98)00455-3) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig 4 A, Incidence of nonfatal stent-graft–related complications among all 103 patients. B, Nonfatal stent-graft complications as a function of the location of the distal stent-graft landing zone. C, Nonfatal stent-graft complications subdivided on the basis of manipulation of the left subclavian artery. SE, Standard error of the estimate; S-G, stent-graft; Abd Ao, abdominal aorta; DsThAo, descending thoracic aorta; LSCA, left subclavian artery; LCCA, left common carotid artery. The Journal of Thoracic and Cardiovascular Surgery 1998 116, 689-704DOI: (10.1016/S0022-5223(98)00455-3) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig 5 Actuarial incidence of the freedom from various stent-graft interventions, including need for coil embolization, repeat stent-graft insertion, and surgical removal* or exclusion of the initial stent-graft. SE, Standard error of the estimate; S-G, stent-graft. *The first patient to receive a stent-graft had the device removed at the time of emergency reoperation for contained rupture (previous coarctation repair 20 years before the stent-graft) 62 months later. This event is not indicated on the graph for stent-graft removal because he was the only remaining patient at risk at that time. The Journal of Thoracic and Cardiovascular Surgery 1998 116, 689-704DOI: (10.1016/S0022-5223(98)00455-3) Copyright © 1998 Mosby, Inc. Terms and Conditions