title: Endovascular management of thoracic aortic aneurysms.
abstract: The overall survival of patients with thoracic aortic aneurysm (TAA) has improved significantly in the past few years. Endovascular treatment, proposed as an alternative to surgery, has been considered a therapeutic innovation because of its low degree of invasiveness, which allows the treatment of even high-surgical risk patients with limited complications and mortality. A major limitation is the lack of adequate evidence regarding long-term benefit and durability because follow-up has been limited to just a few years even in the largest series. The combination of endovascular exclusion with visceral branch revascularization for the treatment of thoraco-abdominal aortic aneurysms involving the visceral aorta has also been attempted. As an alternative, endografts with branches represent a technological evolution that allows treatment of complex anatomy. Even if only small numbers of patients and short follow-up are available, this technical approach, which has with limited mortality (<10%) and paraplegia rates, to expand endovascular treatment to TAA seems feasible. With improved capability to recognize proper anatomy and select clinical candidates, the choice of endovascular stent-graft placement may offer a strategy to optimize management and improve prognosis.
authors.affiliation: Cardiovascular Radiology Unit, Cardio-Thoracic-Vascular Department, University Hospital S. Orsola, Via Massarenti 9, 40128 Bologna, Italy. rossella.fattori@unibo.it
authors.forename: Rossella
authors.initials: R
authors.lastname: Fattori
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Russo
authors.forename: Luigi
authors.initials: L
authors.lastname: Lovato
authors.forename: Katia
authors.initials: K
authors.lastname: Buttazzi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Rinaldi
mesh_terms: D000784:Aortic Dissection / Q000401:mortality / Q000628:therapy; D017542:Aneurysm, Ruptured / Q000401:mortality / Q000628:therapy; D017545:Aortic Aneurysm, Thoracic / Q000401:mortality / Q000628:therapy*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D003952:Diagnostic Imaging; D006801:Humans; D011183:Postoperative Complications / Q000517:prevention & control; D058996:Quality Improvement; D012307:Risk Factors; D013116:Spinal Cord / Q000098:blood supply; D015607:Stents