Key result
Stent graft repair shows no mortality benefit over open surgery but is linked to more endoleaks.
Why the study?
Does stent graft repair improve clinical outcomes compared to open surgery in patients with descending thoracic aortic diseases?
Case-Control (n=72)
Does stent graft repair improve clinical outcomes compared to open surgery in patients with descending thoracic aortic diseases?
Absolute Event Rate: 0% vs 5.6%
p-value: p=0.4930
Stent graft repair is a promising alternative to open surgery for descending thoracic aortic diseases, offering low mortality but requiring careful patient selection to prevent endoleaks.
No mortality difference detected with stent graft repair; leaves open its comparative role pending randomized trials.
OBJECTIVES: Less invasive stent graft (SG) repair was compared with open surgery for patients with descending thoracic aortic diseases. DESIGN: Thirty six patients undergoing SG repair (SG group) were matched for age, sex, location and pathology of aortic disease with a 36-patient surgical cohort (OS group), and retrospective matched case-control study was performed with respect to outcomes and risk factors for adverse outcomes. RESULTS: Mortality rate was 5.6% in OS group and none in SG group (p=0.4930), and there was no significant difference in stroke and paraplegia rates between two groups. A higher prevalence of secondary procedures due to endoleak was seen in the patients of SG group (p=0.0113). Perioperative hypotension was an independent risk factor for in-hospital mortality (p=0.0071, odds ratio=34) and preoperative renal dysfunction was independent risk factor for paraplegia (p=0.0076, odds ratio=17.6). CONCLUSIONS: Although the importance of patient selection is emphasized to prevent endoleak, mortality rate was low in patients who underwent SG repair. SG repair is a promising alternative technique to open surgery for thoracic aortic diseases.
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Nakamura et al. (2008) conducted a case-control in Descending thoracic aortic diseases (n=72). Stent graft (SG) repair vs. Open surgery was evaluated on Mortality rate (p=0.4930). Stent graft repair for descending thoracic aortic diseases had a 0% mortality rate versus 5.6% for open surgery (p=0.4930), but was associated with a higher rate of secondary procedures for endoleak.
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