Mid-term results after endovascular stent-graft placement due to penetrating atherosclerotic ulcers of the thoracic aorta

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To determine mid-term durability of endovascular stent-graft placement in patients with penetrating atherosclerotic ulcers (PAU) involving the thoracic aorta and to identify risk factors for death as well as early and late cardiovascular events.


From 1997 to 2006, 27 patients (mean age 66 yrs) presented with PAU (rupture n = 7). Mean numeric EuroScore was 11 and mean logistic EuroScore was 35. Median follow-up was 42 (10-86) months, being complete in all patients. Outcome variables included death and occurrence of early and late cardiovascular events.


In-hospital mortality was 11%. Primary success rate was 100%. Actuarial survival rates at 1, 3 and 5 years were 93%, 78% and 70%, respectively. Hemodynamic instability (HR 2.5, 2.1-3.9; p = 0.034) as well as logistic EuroScore (HR 2.8, 2.4-4.3; p = 0.019) was identified as independent predictor of early and late cardiovascular events.


Endovascular stent-graft placement in patients with PAU is an effective palliation for a life-threatening sign of a severe systemic process. Hemodynamic instability at referral and a high preoperative risk score predict adverse outcome. During mid-term follow-up, patients are mainly limited by sequelae of their underlying disease.

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