title: Endovascular repair of thoracoabdominal aortic aneurysm (TAAA): early experience.
abstract: BACKGROUND
  Repair of thoracoabdominal aortic aneurysms (TAAA) represents a considerable technical challenge. Since its first description in 1955, open repair of TAAA has been considered the gold standard of repair. Despite improvements in surgical techniques, spinal cord protection and post-operative critical care support, patients who undergo open repair are faced with a mortality rate of 5-35 %. We report the first Irish experience of endovascular management of TAAAs.
  
  
  RESULTS
  To date five patients have undergone endovascular repair; four had hybrid repair and one a fenestrated graft. The mean age of the patients was 66.8 ± 3.4 and the mean aneurysm diameter was 6.74 ± 0.6 cm. All patients were ASA III. Two-stage hybrid repair was associated with an increased risk of complications, prolonged intensive care unit and overall hospital stay. One patient died in the perioperative period due to rupture of their aneurysm between the two stages of their hybrid repair.
  
  
  CONCLUSIONS
  The role of endovascular techniques in the treatment of TAAA continues to evolve. Hybrid and complete endovascular repairs do not replace conventional repair, but provide an alternative for high-risk patients who might otherwise be denied treatment.
authors.affiliation: Department of Vascular and Endovascular Surgery, St. James's Hospital, St. James's Street, Dublin 8, Ireland, rashmed1111@gmail.com.
authors.forename: E A H
authors.initials: EA
authors.lastname: Kheirelseid
authors.forename: R
authors.initials: R
authors.lastname: Gardiner
authors.forename: S N
authors.initials: SN
authors.lastname: Haider
authors.forename: Z
authors.initials: Z
authors.lastname: Martin
authors.forename: M P
authors.initials: MP
authors.lastname: Colgan
authors.forename: S M
authors.initials: SM
authors.lastname: O'Neill
authors.forename: P
authors.initials: P
authors.lastname: Madhavan
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome