[Thoracoabdominal aortic aneurysm].

Area of Science:

• Vascular Surgery
• Cardiovascular Medicine
• Aortic Disease Management

Background:

• Thoracoabdominal aortic aneurysms (TAAA) are rare, affecting 5.9 per 100,000 people annually.
• Degenerative causes are most common, but dissections and connective tissue diseases also contribute.
• Patients frequently present with severe comorbidities like hypertension and COPD, often linked to smoking.

Purpose of the Study:

• To outline current treatment strategies for TAAA.
• To discuss the risks and outcomes associated with TAAA repair.
• To highlight factors influencing treatment decisions and the importance of specialized centers.

Main Methods:

• Review of current surgical and endovascular repair techniques for TAAA.
• Analysis of complication rates, including paraplegia and dialysis necessity.
• Emphasis on patient-specific anatomical assessment and risk stratification.

Main Results:

• Treatment is indicated for aneurysms ≥6 cm or rapid expansion (>5 mm/year).
• Mortality rates for open and endovascular repairs are around 8%, with significant complication risks.
• Patient-specific anatomy and physician assessment guide treatment allocation.

Conclusions:

• TAAA surgery carries substantial risks, necessitating careful patient selection and risk assessment.
• Minimizing complications like paraplegia is an ongoing focus in TAAA management.
• High-volume centers are recommended for TAAA procedures to optimize patient outcomes.