title: Endovascular treatment of descending thoracic aneurysms.
abstract: BACKGROUND
  Current strategies for repair of descending thoracic aortic aneurysms consist of open repair with surgical graft replacement or thoracic endovascular aortic repair. We review and update our overall experience in aortic thoracic diseases and specifically analyzed our outcomes with thoracic endovascular aortic repair in patients with descending thoracic aortic aneurysms.
  
  
  METHODS
  From 1993 to present a total of 1144 patients were treated in our Center for pathology involving the thoracic aorta. Since 1998, 322 patients underwent thoracic endovascular aortic repair, and among this group, in 188 cases the descending aorta was involved. In 74% of patients treated for a descending thoracic aortic lesion, a degenerative aneurysm was observed.
  
  
  RESULTS
  In patients with descending thoracic aortic aneurysms receiving thoracic endovascular aortic repair, our technical success rate, i.e. deployment of endograft with complete exclusion of the lesion/minimal endoleak, was 99.5% (one case required emergent open conversion) with a perioperative mortality of 2.6% (five patients). The rate of spinal cord ischemia, manifesting either as paraplegia or paraparesis, was 4.7%. Delayed onset spinal cord ischemia ameliorated with adequate arterial pressure and cerebrospinal fluid drainage.
  
  
  CONCLUSIONS
  Our experience of selected patients undergoing thoracic endovascular aortic repair of descending thoracic aorta aneurysms is satisfactory with very low mortality and morbidity. A large use of thoracic endovascular aortic repair is foreseen in the next future.
authors: Department of Vascular Surgery, Università Vita-Salute San Raffaele, Milan, Italy.
authors: R
authors: R
authors: Chiesa
authors: E
authors: E
authors: Civilini
authors: Y
authors: Y
authors: Tshomba
authors: E M
authors: EM
authors: Marone
authors: L
authors: L
authors: Bertoglio
authors: D
authors: D
authors: Baccellieri
authors: G
authors: G
authors: Coppi
authors: D
authors: D
authors: Logaldo
authors: G
authors: G
authors: Melissano
keywords: aortic endoprostheses; endovascular aortic repair; thoracic aortic aneurysm; thoracic aortic aneurysms; type B aortic dissection