Endovascular management of thoracic aortic aneurysms

Area of Science:

• Vascular Surgery
• Medical Device Technology
• Aortic Disease Management

Background:

• Thoracic aortic aneurysm (TAA) management has improved, with endovascular treatment emerging as a less invasive alternative.
• Endovascular repair offers benefits for high-surgical risk patients, but long-term durability data is still limited.
• Treatment of thoraco-abdominal aortic aneurysms involving the visceral aorta presents unique challenges.

Purpose of the Study:

• To evaluate the feasibility and outcomes of endovascular treatment for thoracic aortic aneurysms (TAA).
• To assess the role of branched endografts in managing complex thoraco-abdominal aortic aneurysms.
• To explore the potential of endovascular stent-graft placement in optimizing TAA management and prognosis.

Main Methods:

• Review of endovascular treatment approaches for TAA, including branched endografts.
• Analysis of limited patient numbers and short-term follow-up data for complex aortic repairs.
• Assessment of mortality and complication rates, including paraplegia, associated with endovascular techniques.

Main Results:

• Endovascular treatment demonstrates low invasiveness, enabling management of high-risk patients with reduced complications and mortality.
• Branched endografts represent a technological advancement for treating complex aortic anatomy, showing promise in small patient cohorts.
• Limited data suggests feasibility of endovascular approaches for TAA with acceptable mortality (<10%) and paraplegia rates.

Conclusions:

• Endovascular repair is a feasible strategy for TAA, particularly for high-risk individuals.
• Branched endografts offer a viable solution for complex thoraco-abdominal aortic aneurysms, expanding endovascular capabilities.
• Improved patient selection and anatomical recognition can optimize endovascular stent-graft placement for better TAA prognosis.