title: Current results of total endovascular repair of thoracoabdominal aortic aneurysms.
abstract: Minimally invasive surgical solutions for patients with extensive aortic disease are eagerly awaited, since open repair is often associated with high rates of morbidity and mortality. In the last decade, the development of fenestrated and branched aortic endografts has offered a therapeutic option to patients deemed unsuitable for major surgery. Preliminary studies showed promising early results, while mid- and long- term data are scarce. The aim of this paper was to review current results of total endovascular repair of thoracoabdominal aortic aneurysms (TAAA) with a single model of endograft in the published literature. A literature search was conducted, and our two-center experience with fenestrated and branched endografts in the treatment of TAAA, with the Cook Zenith endograft, is presented. Early results show perioperative mortality rates ranging from 0% to 21%, spinal cord ischemia from 0% to 33.3%. At a mean follow up ranging from 9 to 19 months, reinterventions are needed in 3.3% to 25% of the cases, with a mid term visceral branch patency of 90% to 100%. Current experiences with total endovascular TAAA repair show promising results, in selected centers with large experience in complex aortic endografting. With increasing follow- up times, need for reintervention is growing, while aneurysm-related deaths remain rare. Long-term results are still lacking, but these encouraging data and further technological developments will support wider adoption of the technique.
authors.affiliation: Unit of Vascular and Endovascular Surgery University of Perugia, Santa Maria della Misericordia Hospital, Perugia, Italy:2 Unit of Vascular Surgery, Department of Cardiosciences, S. Camillo-Forlanini Hospital, Rome, Italy - fabio.verzini@unipg.it.
authors.forename: F
authors.initials: F
authors.lastname: Verzini
authors.forename: D
authors.initials: D
authors.lastname: Loschi
authors.forename: P
authors.initials: P
authors.lastname: De Rango
authors.forename: C
authors.initials: C
authors.lastname: Ferrer
authors.forename: G
authors.initials: G
authors.lastname: Simonte
authors.forename: C
authors.initials: C
authors.lastname: Coscarella
authors.forename: G
authors.initials: G
authors.lastname: Pogany
authors.forename: P
authors.initials: P
authors.lastname: Cao
mesh_terms: D017545:Aortic Aneurysm, Thoracic / Q000401:mortality / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D006801:Humans; D011183:Postoperative Complications / Q000401:mortality / Q000628:therapy; D011474:Prosthesis Design; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome