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J Thorac Cardiovasc Surg 2006;131:131-137
© 2006 The American Association for Thoracic Surgery

Evolving Technology

Stent-graft repair for thoracic aortic disease: Results of an independent nationwide study in France from 1999 to 2001

Jean-Baptiste Ricco, MD, PhD a , * , Jérome Cau, MD a , Christophe Marchand, MD a , Michel Marty, MD b , Marie-Hélène Rodde-Dunet, MD b , Pierre Fender, MD b , Hubert Allemand, MD b , Andrew Corsini, BA a

a Vascular Surgery Department, University Hospital, Poitiers, France
b French National Health Insurance Fund for Salaried Workers, French Ministry of Health, Paris, France

Received for publication February 9, 2005; revisions received July 11, 2005; accepted for publication July 19, 2005.

* Address for reprints: Jean-Baptiste Ricco, MD, PhD, Department of Vascular Surgery, University Hospital of Poitiers, rue de la Miletrie, 86000 Poitiers, France (Email: j.b.ricco{at}chu-poitiers.fr).

BACKGROUND: The purpose of this study was to assess the overall short-term outcome of stent-graft repair for thoracic aortic disease in France between June 1999 and May 2001.

METHODS: This retrospective study was designed by the French National Health Insurance Fund for Salaried Workers. To ensure objectivity, data were retrieved at each center and checked by a team of medical advisors.

RESULTS: Between June 1999 and May 2001, a total of 166 stent-graft repairs for thoracic aortic disease were performed in 166 patients, mainly by surgeons in the operating room (88%). Patients were classified according to the American Society of Anesthesiologists as status I or II in 24% of cases, status III in 56%, and status IV or V in 20%. The diameter of the thoracic aneurysm was less than 50 mm in 17% of cases. Seventeen patients (10%) died during the first 3 months, including 8 within the first 30 days after the procedure. A total of 49 complications were noted in 34 patients (20.5%). Endoleaks occurred in 27 patients (16.3%), including 8 that necessitated further treatment. Other stent-related complications included rupture (n = 3), aortoesophageal or tracheal fistula (n = 3), paraplegia (n = 6), stent migration (n = 2), visceral embolism (n = 5), and cerebral embolism (n = 2). There were 14 delivery-related complications (8%) at the catheterization site. Non–stent-related complications occurred in 14 (8%).

CONCLUSIONS: This nationwide study demonstrates that stent-graft repair for thoracic aortic disease can be performed with acceptable postoperative morbidity. However, it is not a risk-free procedure and should continue to be used in an investigative setting.

Abbreviations and Acronyms ASA = American Society of Anesthesiologists; CI = 95% confidence interval; TAD = thoracic aortic disease


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