Recent advances in thoraco-abdominal aortic aneurysm repair

Area of Science:

• Vascular Surgery
• Endovascular Interventions
• Aortic Aneurysm Repair

Background:

• Traditional thoraco-abdominal aortic aneurysm repair involves open surgery with high morbidity and mortality.
• Advances in critical care and surgical techniques have improved outcomes but challenges remain.

Purpose of the Study:

• To review the history and evolution of thoraco-abdominal aortic aneurysm repair.
• To discuss modern approaches including hybrid and endovascular techniques.
• To present an approach to managing thoraco-abdominal aortic aneurysms in the 21st century.

Main Methods:

• The St Mary's visceral hybrid repair combines open visceral revascularization with endovascular stent grafting.
• Minimally invasive endovascular stent grafting, including customized grafts, is increasingly utilized.
• Review of historical data and contemporary outcomes.

Main Results:

• Hybrid repair in specialist centers shows encouraging results comparable to open repair.
• Wholly endovascular repair is feasible for select anatomies, representing future treatment directions.
• These advanced techniques avoid thoracotomy and aortic cross-clamping, reducing surgical trauma.

Conclusions:

• The St Mary's hybrid repair is a robust and transferable method for thoraco-abdominal aortic aneurysms.
• Customized endovascular stent grafts are the future of thoraco-abdominal aortic aneurysm repair for suitable patients.
• Continued innovation in endovascular technology is crucial for advancing aortic aneurysm treatment.