To investigate the transient computed tomographic (CT) findings and morphological characteristics of the descending thoracic aorta following endovascular repair of thoracic aortic aneurysm (TAA).
Methods:
Of 50 TAAs repaired using custom-made endoprostheses between May 1997 and September 2005, 35 (25 men; mean age 67 years) were successfully treated and followed for >3 months by thoracic CT. The TAA etiologies were 22 degenerative/atherosclerotic, 7 dissection-related from intramural hematoma, 2 traumatic, 2 anastomotic, and 2 penetrating ulcers. The CT findings following stent-graft placement were retrospectively studied.
Results:
Over a mean followup of 27.0625 months (range 3–92), periaortic changes were observed in 17 (48.6%) patients, and the amount of pleural effusion increased in 13 (37.1%). In all cases, these findings disappeared without specific treatment during the followup period. Late secondary endoleak was observed in 1 (2.9%) patient, and there was 1 (2.9%) caudal migration of the proximal end of the stent-graft. Five (14.3%) aneurysms increased in size. Two patients, both with dissection, showed aortic neck dilatation. There was a positive relationship between neck dilatation and dissection-related TAA etiology (p=0.035).
Conclusion:
Although aortic neck dilatation is less common after endovascular TAA repair than after abdominal repairs, patients with dissection-related TAA may be a subgroup prone to aneurysm neck dilatation.
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