Novel Aortic Reconstruction Strategies: Endovascular Aneurysm Repair

New technology has given vascular surgeons novel treatment options for aortic diseases. Endovascular aortic aneurysm repair is a minimally invasive technique that uses a graft to reconstruct an aneurysmal segment without laparotomy, aortic incision, or cross-clamping. The procedure results in less pain and suffering for patients and requires fewer health care resources. Although still experimental in the United States, this operation has become routine in several centers in Australia and Europe. Collective experience with endovascular repair has yielded complication and mortality results that compare favorably with those from leading studies of conventional repair, despite significant medical comorbidity among its cohorts. The durability of contemporary endovascular repair approaches, but does not yet equal, that of conventional surgery. However, in conditions such as complicated aortic dissection, the new technique may be superior. In this review we describe endovascular devices and their selection and discuss results of the largest contemporary studies.