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Published on: March 28, 2025
Endovascular repair for thoracic aortic arch aneurysms
R Caronno1, G Piffaretti, M Tozzi
1Division of Vascular Surgery, Department of Surgery, University of Insubria, Varese, Italy.
Summary
Endovascular repair of thoracic aortic arch aneurysms is feasible in high-risk patients. This technique, combining stent-grafts with branch revascularization, showed a 100% technical success but requires further long-term study.
Area of Science:
- Vascular Surgery
- Endovascular Interventions
- Aortic Aneurysm Repair
Background:
- Thoracic aortic arch aneurysms pose significant risks for open surgical repair.
- High-risk patients often require alternative treatment strategies.
Purpose of the Study:
- To evaluate the safety and efficacy of endovascular stent-grafting combined with aortic arch branch revascularization.
- To report outcomes in high-risk patients with thoracic aortic arch aneurysms.
Main Methods:
- Retrospective analysis of 10 high-risk patients undergoing endovascular repair between 2000 and 2005.
- Procedures included total/subtotal arch stent-grafting with extra-anatomical revascularization for inadequate landing zones.
- Techniques involved left subclavian artery over-stenting or simultaneous revascularization of arch branches.
Main Results:
- 100% primary technical success rate with no in-hospital mortality.
- No cases of paraplegia or acute renal failure reported.
- Mean follow-up of 21 months; survival rates at 12, 26, and 36 months were 90%, 60%, and 30% respectively.
Conclusions:
- Endovascular repair is a feasible option for thoracic aortic arch aneurysms in select high-risk patients.
- The technique demonstrates promising short-term results but carries inherent risks.
- Long-term data and larger studies are necessary to fully assess outcomes.
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