Primary endoleakage in endovascular treatment of the thoracic aorta: Importance of intraoperative transesophageal echocardiography

被引:43
作者
Fattori, R
Caldarera, I
Rapezzi, C
Rocchi, G
Napoli, G
Parlapiano, M
Favali, M
Pierangeli, A
Gavelli, G
机构
[1] Univ Bologna, Dept Radiol, Bologna, Italy
[2] Univ Bologna, Dept Cardiovasc Surg, Bologna, Italy
[3] Univ Bologna, Dept Cardiol, Bologna, Italy
关键词
D O I
10.1067/mtc.2000.108904
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives: Endovascular treatment of the thoracic aorta has developed as an efficacious alternative to open surgical repair. However, despite the high primary success rate, perigraft leakage constitutes the major concern in longterm follow-up. Endoleaks are widely reported both in abdominal and thoracic endovascular series and are usually identified by intraoperative angiography. Transesophageal echocardiography is a sensitive imaging technique in the evaluation of aortic diseases, widely used to monitor cardiac surgery. The aim of this study was to evaluate the efficacy of transesophageal echocardiography in leakage detection during endovascular stent procedures of the thoracic aorta. Methods: Intraoperative transesophageal echocardiography was used in conjunction with angiography in 25 patients subjected to endovascular stent treatment of the descending thoracic aorta. Spiral computed tomographic scanning was performed before discharge and 3, 6, and 13 months after treatment. Results: Information from transesophageal echocardiography was relevant in the selection of the landing zone in 62% of cases. In 8 patients, transesophageal echocardiography with color Doppler sonography showed a perigraft leak, 6 of which were not visible on angiography, suggesting the need for further balloon expansion or graft extension. Postoperative computed tomographic scanning in the 25 patients showed I endoleak, which sealed spontaneously. Al 3 months, computed tomographic examination confirmed the absence of perigraft leakage in all patients. Conclusions: During implantation of a stent-graft in the descending thoracic aorta, transesophageal echocardiography provides information in addition to that provided by angiography, improving immediate and late procedural results.
引用
收藏
页码:490 / 495
页数:6
相关论文
共 22 条
  • [1] Rupture of an abdominal aortic aneurysm after endovascular graft placement and aneurysm size reduction
    Alimi, YS
    Chakfe, N
    Rivoal, E
    Slimane, KK
    Valerio, N
    Riepe, G
    Kretz, JG
    Juhan, C
    [J]. JOURNAL OF VASCULAR SURGERY, 1998, 28 (01) : 178 - 183
  • [2] DOPPLER ECHOCARDIOGRAPHIC EVALUATION OF PSEUDOANEURYSMS COMPLICATING COMPOSITE GRAFTS OF THE ASCENDING AORTA
    BARBETSEAS, J
    CRAWFORD, ES
    SAFI, HJ
    COSELLI, JS
    QUINONES, MA
    ZOGHBI, WA
    [J]. CIRCULATION, 1992, 85 (01) : 212 - 222
  • [3] Improved prognosis of thoracic aortic aneurysms - A population-based study
    Clouse, WD
    Hallett, JW
    Schaff, HV
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1998, 280 (22): : 1926 - 1929
  • [4] THORACOABDOMINAL AORTIC-ANEURYSMS - PREOPERATIVE AND INTRAOPERATIVE FACTORS DETERMINING IMMEDIATE AND LONG-TERM RESULTS OF OPERATIONS IN 605 PATIENTS
    CRAWFORD, ES
    CRAWFORD, JL
    SAFI, HJ
    COSELLI, JS
    HESS, KR
    BROOKS, B
    NORTON, HJ
    GLAESER, DH
    [J]. JOURNAL OF VASCULAR SURGERY, 1986, 3 (03) : 389 - 404
  • [5] Endovascular stent-graft placement for the treatment of acute aortic dissection
    Dake, MD
    Kato, N
    Mitchell, RS
    Semba, CP
    Razavi, MK
    Shimono, T
    Hirano, T
    Takeda, K
    Yada, I
    Miller, DC
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1999, 340 (20) : 1546 - 1552
  • [6] TRANSLUMINAL PLACEMENT OF ENDOVASCULAR STENT-GRAFTS FOR THE TREATMENT OF DESCENDING THORACIC AORTIC-ANEURYSMS
    DAKE, MD
    MILLER, DC
    SEMBA, CP
    MITCHELL, RS
    WALKER, PJ
    LIDDELL, RP
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1994, 331 (26) : 1729 - 1734
  • [7] DOLAZARIAN J, 1997, RADIOLOGY, V202, P731
  • [8] Endovascular stent graft repair for aneurysms on the descending thoracic aorta
    Ehrlich, M
    Grabenwoeger, M
    Cartes-Zumelzu, F
    Grimm, M
    Petzl, D
    Lammer, J
    Thurnher, S
    Wolner, E
    Havel, M
    [J]. ANNALS OF THORACIC SURGERY, 1998, 66 (01) : 19 - 24
  • [9] Freeman WK, 1994, TRANSESOPHAGEAL ECHO
  • [10] Traumatic thoracic aortic aneurysm: Treatment with endovascular stent-grafts
    Kato, N
    Dake, MD
    Miller, DC
    Semba, CP
    Mitchell, RS
    Razavi, MK
    Kee, ST
    [J]. RADIOLOGY, 1997, 205 (03) : 657 - 662