Follow-up
No patient required unplanned intervention on distal aorta. Fifteen patients (26.8%) underwent a scheduled second stage (Figure 3): 12 aneurysms extending to the distal portion of the descending aorta, 2 thoracoabdominal aorta aneurysms and 1 type A chronic aortic dissection. Thirteen patients were treated endovascularly (12 thoracic endovascular aortic repair -TEVAR- and 1 fenestrated/branched endovascular aneurysm repair), 1 patient underwent an open repair and 1 patient a hybrid approach (TEVAR extension of E-vita Open prosthesis and subsequently open repair of distal aorta).
Mid-term clinical follow-up was achieved for all the patients (mean follow up: 20.9±18 months). One- and three-year overall survival was 90.7% and 80.7% (Figure 4). Three patients underwent a reintervention during the follow-up. Reasons were type Ib endoleak (n=1), pseudoaneurysm of the supra-aortic arteries patch anastomosis (n=1) and a distal false lumen enlargement in a Type A chronic dissection.
In acute and chronic dissections, a follow-up CT scan at 3 months was available in 24/26 patients. No stent induced new entry was detected. Complete thrombosis at mid portion of the stent-grafted aortic segment was observed in 79.2% of patients (87.5% in acute dissection and 62.5% in chronic dissection, p=0.2) and at its distal aspect in 50% (56.3% in acute dissection and 37.5% in chronic dissection, p=0.6). Distal to the stent graft, complete false lumen perfusion remained in 62.5% (50% in acute dissection and 85.7% in chronic dissection, p=0.1).