Endovascular repair of thoracic aortic aneurysms.
A thoracic aortic aneurysm is a potentially life-threatening condition that involves a structural weakness of the aortic wall, which can lead to aneurysm, rupture, or dissection. Optimal treatment strategies for lesions of the thoracic aorta are still controversial. Open surgery is complex and is associated with significant morbidity and mortality. Endovascular stenting has emerged as an alternative to open repair in patients requiring surgery for thoracic aortic pathology. Endovascular treatment of vascular disease involving the descending thoracic aorta can be performed safely. It is an alternative option to open repair, less invasive, and carries a relatively low risk. Due to the low morbidity and mortality of endovascular repair, this option has become attractive to many surgeons lately. Stent grafting has become the first-line approach to traumatic thoracic aortic transections in some trauma centers. However, the challenges of accurate placement within an angulated arch, size of the delivery system, and uncertainty regarding long-term durability have been cited as reasons for caution. Major challenges are the technical aspects of the procedure and the learning curve to handle the delivery system and the variability in the anatomy of the aorta. The goal of this article is to review endovascular repair of the thoracic aorta in the current literature outlining some recent patents.
Neragi-Miandoab
Siyamek
S
Department of Surgery, St. Vincent's Medical Center, School of Medicine, New York Medical College, New York, NY 10011, USA. sneragi@yahoo.com
Bernik
Thomas
T
D000818:Animals; D017545:Aortic Aneurysm, Thoracic / Q000473:pathology / Q000601:surgery*; D004730:Endothelium, Vascular / Q000473:pathology / Q000601:surgery*; D006801:Humans; D015607:Stents; D016378:Tissue Transplantation / Q000295:instrumentation / Q000379:methods; D014656:Vascular Surgical Procedures / Q000295:instrumentation* / Q000379:methods