Stent-graft placement procedures for descending thoracic aortic aneurysms

Descending thoracic aortic aneurysms most often are caused by arteriosclerosis and appear most frequently in elderly males. These patients often are asymptomatic, but they may experience symptoms related to compression of adjacent thoracic structures, or they may present for treatment when their-aneurysms rupture. Open surgical resections and repairs of descending thoracic aortic aneurysms are associated with bleeding, paraplegia, strokes, renal insufficiency, and the need for prolonged ventilatory support in the postoperative period. At Stanford (Calif) University Hospital, surgeons are placing endovascular stent-grafts in patients with descending thoracic aortic aneurysms who meet specific anatomic selection criteria. This new treatment modality provides patients with a less invasive, less hazardous, and potentially less expensive alternative to open surgical resection and repair procedures. Preoperative teaching and skilled perioperative nursing care are essential for positive patient outcomes with stent-graft treatment of descending thoracic aortic aneurysms.