title: Open versus Endovascular Repair of Arch and Descending Thoracic Aneurysms: A Retrospective Comparison.
abstract: BACKGROUND
  Thoracic aortic aneurysms (TAAs) contribute significant mortality if left untreated, but surgical repair has historically carried substantial risks.
  
  
  METHODS
  We sought to observe trends and outcomes of open and endovascular thoracic endovascular aneurysm repair thoracic aortic repairs, so conducted a retrospective review of all patients who presented for management of TAAs from 2003 to 2013 at 2 hospitals in Sydney, Australia.
  
  
  RESULTS
  A total of 179 patients presented with TAAs over the study period, including 5 ruptures. Fifty-two were treated nonoperatively, with 127 surgically repaired. Operative duration was significantly shorter in endovascular than open repair of arch (193 ± 108 vs. 396 ± 98 min, P = 0.0001) and descending aneurysms (242 ± 116 vs. 422.5 ± 161 min, P = 0.003). There were no differences in mortality or complication rates (including paraplegia), duration of hospital or intensive care unit stay, or transfusion requirements between endovascular and open TAA repairs.
  
  
  CONCLUSIONS
  Apart from reduced surgical duration, this study revealed no benefits of endovascular over open TAA repair. Overall morbidity and mortality were low, even in elderly patients.
authors.affiliation: Department of Vascular Surgery, Royal Prince Alfred Hospital, Camperdown, NSW, Australia; School of Medicine, The University of Notre Dame, Darlinghurst, NSW, Australia. Electronic address: timothy.shiraev1@my.nd.edu.au.
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Shiraev
authors.affiliation: Department of Vascular Surgery, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.
authors.forename: Raffi
authors.initials: R
authors.lastname: Qasabian
authors.affiliation: School of Medicine, The University of Notre Dame, Darlinghurst, NSW, Australia.
authors.forename: Daniel
authors.initials: D
authors.lastname: Tardo
authors.affiliation: School of Medicine, The University of Notre Dame, Darlinghurst, NSW, Australia.
authors.forename: Gemille
authors.initials: G
authors.lastname: Ninic
authors.affiliation: School of Medicine, The University of Notre Dame, Darlinghurst, NSW, Australia.
authors.forename: Zelda
authors.initials: Z
authors.lastname: Doyle
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D001019:Aortic Rupture / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001803:Blood Transfusion; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality / Q000639:trends; D057510:Endovascular Procedures / Q000009:adverse effects / Q000401:mortality / Q000639:trends; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome