title: Management of thoracic aortic lesions--the future is endovascular.
abstract: Open surgical repair of lesions of the descending thoracic aorta, such as aneurysm, dissection and traumatic rupture, has been the "state-of-the-art" treatment for many decades. However, in specialized cardiovascular centers, thoracic endovascular aortic repair and hybrid aortic procedures have been implemented as novel treatment options. The current clinical results show that these procedures can be performed with low morbidity and mortality rates. However, due to a lack of randomized trials, the level of reliability of these new treatment modalities remains a matter of discussion. Clinical decision-making is generally based on the experience of the vascular center as well as on individual factors, such as life expectancy, comorbidity, aneurysm aetiology, aortic diameter and morphology. This article will review and discuss recent publications of open surgical, hybrid thoracic aortic (in case of aortic arch involvement) and endovascular repair in complex pathologies of the descending thoracic aorta.
authors.affiliation: Division of Vascular and Endovascular Surgery, Ludwig-Maximilian-University of Munich, Germany. rolf.weidenhagen@med.uni-muenchen.de
authors.forename: Rolf
authors.initials: R
authors.lastname: Weidenhagen
authors.forename: René
authors.initials: R
authors.lastname: Bombien
authors.forename: Georgios
authors.initials: G
authors.lastname: Meimarakis
authors.forename: Gerrit
authors.initials: G
authors.lastname: Geisler
authors.forename: Thomas Andreas
authors.initials: TA
authors.lastname: Koeppel
mesh_terms: D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D057510:Endovascular Procedures / Q000009:adverse effects; D019317:Evidence-Based Medicine; D006801:Humans; D018579:Patient Selection; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000000981:diagnostic imaging / Q000601:surgery*