Endovascular treatment of ascending aortic pathologies: a single center experience

BACKGROUND: Thoracic endovascular aortic repair (TEVAR) provides an alternative treatment option for selected patients with ascending aortic diseases harboring a high surgical risk. Herein we report our experience with this technique in different ascending aortic pathologies.METHODS: From May 2016 to May 2021, 5 patients were treated in our institution with TEVAR for different ascending aortic pathologies. Medical files were reviewed retrospectively to analyze the technique and postoperative results. Median age was 83. One patient had intramural hematoma, another had mycotic false aneurysm and three had acute type A aortic dissections. Mean Euroscore was 17.69.RESULTS: Overall survival was 80% over a median follow-up of 20 months (one peroperative death). Exclusion of the entry tear and the aortic pathology was successful in all the patients. Type 1 endoleak developed in 2 patients with no need for additional endovascular procedure. No cerebrovascular complications were recorded.CONCLUSIONS: Surgery remains the gold standard treatment in ascending aortic pathology even in high-risk patients. The key to success of TEVAR is the appropriate patient selection. The main pitfall remains the lack of dedicated stent for the ascending aorta.