Thoracic stent graft versus surgery for thoracic aneurysm

Area of Science:

• Vascular Surgery
• Cardiovascular Research
• Medical Interventions

Background:

• Thoracic aortic aneurysm (TAA) is a rare condition with unpredictable enlargement, potentially leading to rupture.
• Conventional open chest surgical repair carries significant perioperative risks.
• Thoracic endovascular aneurysm repair (TEVAR) is a less invasive alternative, but requires further evidence.

Purpose of the Study:

• To assess the efficacy of TEVAR compared to conventional open surgery for TAAs.
• To review existing randomized controlled trials on TEVAR versus open surgery for TAAs.

Main Methods:

• Searched Cochrane databases for randomized controlled trials (RCTs) up to October 2008.
• Included RCTs comparing TEVAR and open surgical repair for TAAs.
• Two reviewers independently assessed trial eligibility; no statistical analysis was performed due to lack of RCTs.

Main Results:

• No published or unpublished randomized controlled trials were identified comparing TEVAR with conventional open surgical repair for TAAs.

Conclusions:

• While technically feasible, TEVAR requires high-quality randomized controlled trials.
• Further research should assess outcomes like paraplegia, mortality, hospital stay, open-conversion, aneurysm exclusion, endoleaks, and late mortality.
• Evidence is needed to support TEVAR over open surgery for TAA treatment.