PURPOSE: Endovascular surgery is thought to have a low risk of pulmonary embolism (PE). We assessed the silent pulmonary embolism after Thoracic endovascular aortic repair (TEVAR) at our institution.
METHODS: Data were reviewed retrospectively for 90 patients (72 male; mean age74 years (30-88years)) who underwent TEVAR in 56 distal aortic arch aneurysms, and 34 aneurysm of descending aorta between September 2001 and April 2011. Devices utilized were homemade (n=61 ; 67.8%), Gore TAG (n=21 ;23.3%) and Medtronic Talent (n=8 ;8.9%). 75 patients were treated to a right brachial artery for delivery a stent graft and digital subtraction angiography (67 patients were punctured directly percutaneously and were required the astriction of a right arm of the about half day time.) . Enhanced computed tomography (CT) was performed a week after TEVAR.
RESULTS: PE was detected in 18 patients (20%) in postoperative CT (right lobe ;13, left lobe ;5). All of them were included in the group who were treated to a right brachial artery (17 patients were punctured a right brachial artery and required the astriction of a right arm; 25.4%). All patients with PE after TEVAR had no symptom.
CONCLUSIONS: Patients who performed TEVAR may have a certain risk of pulmonary embolism. Puncture to a right brachial artery and astriction of a right arm were thought about as one of the etiology of PE.
CLINICAL IMPLICATIONS: TEVAR have a low stress treatment or a short operative time. Since a risk of PE was regarded as low after TEVAR, and patients with high risks are selected for TEVAR. As results, decrease of ADL after TEVAR, patients with high risks may have a certain risk of PE.
DISCLOSURE: The following authors have nothing to disclose: Takeshi Okamoto, Kazuhiko Hanzawa, Osamu Namura, Masaru Takekubo, Jun-ichi Hayashi
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