Advances in Thoracic Aortic Aneurysms Repair

Abstract

Management of a patient with descending thoracic aortic aneurysms is a challenging entity. Selection of appropriate management modality either continuous medical treatment or intervention which could be either surgical or endovascular repair is rather controversial. Open surgical repair had considerable rates of perioperative mortality and morbidity, the most devastating of which are paraplegia, stroke and renal insufficiency. Endovascular repair offered these advantages, with significantly better early mortality rates, less paraplegia, stroke and renal insufficiency, along with significant decrease in ICU and hospital stay. However, Endovascular repair shows added especial complications as endoleaks, stent migration, and high rates of secondary intervention. The continuous evolution in open surgical technique and the new advances in the surgical adjuvants have now greatly reduced the complications rates to be comparable to those of endovascular repair.

Key Words: Thoracic, aneurysm, endovascular, TEVAR, open repair.