Endovascular Treatment of Aortic Disease

A review is given of endovascular treatment for AAA, thoracic aortic aneurysms, dissections as well as complications following previous aortic surgery. In several of these conditions endovascular treatment has advantages like a reduced operative trauma, shorter stay in hospital, and the possibility of treating patients who would have been unfit for open surgery. On the other hand, problems like endoleak, deformation of the endoprosthesis, retrograde filling of the aneurysmal sack, and graft limb occlusion need to be solved before the place of endovascular treatment can be defined. It is possible that the steadily improving quality of the implants as well as the introducer systems will widen the indications for endovascular surgery, but randomised clinical trials are warranted and a longer follow-up period is necessary to draw final conclusions.