Related Experiment Video
Updated: Jun 14, 2026
04:56
Modified Octopus Technique for Thoracoabdominal Aortic Aneurysm
Published on: August 1, 2025
Thoraco-abdominal aortic aneurysm branched repair
E L G Verhoeven1, I F J Tielliu, M Ferreira
1Department of Vascular and Endovascular Surgery, Nürnberg Süd Clinic, Nürnberg, Germany. Eric.Verhoeven@klinikum-nuernberg.de
The Journal of Cardiovascular Surgery
|April 1, 2010
Summary
Endovascular repair of thoraco-abdominal aortic aneurysms offers lower mortality and morbidity than open surgery. Ongoing technical advancements in branched grafts are improving outcomes and patient impact.
Area of Science:
- Vascular Surgery
- Endovascular Interventions
- Aortic Aneurysm Treatment
Background:
- Open repair of thoraco-abdominal aortic aneurysms is complex, with high mortality (3-21%) and morbidity (renal failure, paraplegia).
- Endovascular repair evolved from fenestrated grafts for complex abdominal aneurysms to branched grafts for thoraco-abdominal aneurysms.
Purpose of the Study:
- To provide a comprehensive review of the technical aspects and outcomes of endovascular repair for thoraco-abdominal aortic aneurysms.
- To compare endovascular repair with open surgical repair in terms of safety and efficacy.
Main Methods:
- Review of available literature on endovascular repair of thoraco-abdominal aortic aneurysms using branched grafts.
- Analysis of technical aspects, mortality, morbidity, and long-term patency rates.
Main Results:
- Endovascular repair mortality rates are below 10%, with spinal cord ischemia reported between 2.7% and 20%.
- Target vessel branch patency is high (95-100%), with promising mid-term durability.
- Most studies included high-risk patients unsuitable for open repair.
Conclusions:
- Endovascular repair of thoraco-abdominal aortic aneurysms is a viable alternative to open repair, especially for high-risk patients.
- Ongoing technical evolution of branched grafts is enhancing ease of use and potentially improving outcomes.
- Endovascular repair is expected to increasingly replace open repair due to its lower physical impact on patients.
Related Concept Videos
01:26Aneurysm III: Interprofessional Care
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
01:15Thoracic Aorta
The thoracic section of the aorta begins at the T5 vertebra and extends to the T12 level at the diaphragm, initially progressing through the mediastinum to the left of the spinal column. Throughout its course in the thoracic segment, the thoracic aorta emits various offshoots known collectively as visceral and parietal branches. The branches that predominantly supply blood to visceral organs are termed visceral branches and include bronchial, pericardial, esophageal, and mediastinal arteries,...
01:30Aneurysm I: Introduction
An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies
Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...