[Diagnosis and endovascular treatment of thoracic aortic diseases]

Recent years have seen the emergence of non-invasive imaging techniques for the morphological assessment of the thoracic aorta. This evolution results in an important reduction of the role of diagnostic angiography. Simultaneously, thanks to a tremendous technologic development, endovascular treatment techniques concern nowadays some pathologic conditions of the descending aorta. A number of reports using a variety of devices have been published in the literature concerning the treatment of dissection and aortic aneurysm. Based on mid-term results, endoluminal repair with use of stent-grafts is a feasible and safe alternative to surgery with a low rate of morbidity and mortality. In type B dissections with end-organ involvement, interventional radiology can be used either to fenestrate the flap or to stent the flap in branch arteries. Proper selection of patients by non-invasive imaging is fundamental for successful endoluminal treatment. However, there is still major concern with respect to long term results of these new treatments.