Authors

• Vjekoslav Tomulić — University of Rijeka School of Medicine, University Hospital Centre Rijeka, Rijeka,Croatia — ORCID: 0000-0002-3749-5559
• Tomislav Jakljević — University of Rijeka School of Medicine, University Hospital Centre Rijeka, Rijeka,Croatia — ORCID: 0000-0002-3692-0111
• David Gobić — University of Rijeka School of Medicine, University Hospital Centre Rijeka, Rijeka,Croatia — ORCID: 0000-0001-9406-1127
• Miljenko Kovačević — University of Rijeka School of Medicine, University Hospital Centre Rijeka, Rijeka,Croatia
• Davor Primc — University of Rijeka School of Medicine, University Hospital Centre Rijeka, Rijeka,Croatia

Keywords

aortic disease, acute aortal syndrome, thoracic endovascular aortic repair, endovascular aortic repair

DOI

Full Text

Aortic disease includes aortic aneurysm, acute aortic syndrome (AAS): dissection, intramural haematoma, penetrating atherosclerotic ulcer, traumatic aortic injury; pesudoaneurysm, aortic rupture and atherosclerotic or inflammatory aortic disease. Aneurysms of abdominal (AAA) or thoracic (TAA) aorta are most common. They have long-lasting subclinical course and AAS is often first manifestation of the disease, with extremely poor prognosis. (1-3) Endovascular repair of abdominal (EVAR) and thoracic (TEVAR) aorta with graft stents is preferred method of treatment over open surgical procedure. Length of stay in ICU, hospitalisation duration, acute complications, rate of recovery and survival over 5 years are all, according to clinical studies, on EVAR/TEVAR side. Open surgery kept its position in treating disease of ascending aorta and aortic arch. Development of new techniques and devices enables endovascular treatment of high-risk patients (thoracoabdominal aneurysms, „hostile“ neck) who were deemed inoperable until now. In University Hospital Centre Rijeka we performed 49 endovascular procedures (TEVAR 20, EVAR 29) from 2014 to 2016. 14 patients (28,6%) have had an emergency procedure because of AAS. Majority of procedures were performed percutaneously (30 patients, 61%). Periprocedural mortality was 2% (1 patient), 30-days mortality was 8.1% (4 patients). Further development needs stabile financing and additional education and integration of multidisciplinary endovascular team (vascular surgeons, interventional radiologists and cardiologists).

Literature

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