REVIEW  THORACIC AORTIC CHALLENGES 

Italian Journal of Vascular and Endovascular Surgery 2020 March;27(1):52-68

DOI: 10.23736/S1824-4777.20.01436-9

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Endovascular TAAA repair: current status and future challenges

Emanuel R. TENORIO, Francesco SQUIZZATO, Parvathi BALACHANDRAN, Gustavo S. ODERICH ✉

Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, MN, USA

Open surgical repair has been the gold standard for treatment of thoracoabdominal aortic aneurysms (TAAAs). Currently open surgical repair has been reserved mostly for young and fit patients with connective tissue disorders, using separate branch vessel reconstructions instead of ‘island’ patches, and distal perfusion instead of “clamp-and-go” technique. Endovascular repair has been gaining widespread acceptance because of its potential to significantly decrease morbidity and mortality. Several large aortic centers have developed dedicated clinical programs to advance techniques of fenestrated-branched endovascular repair (FBEVAR) using patient-specific and off-the-shelf devices, offering a minimally invasive alternative to open repair allowing treatment of increasingly older and sicker TAAA patients. In this article, we review the current technical aspects of endovascular TAAA repair and the literature of open versus endovascular outcomes of TAAA repair.

KEY WORDS: Thoracic aortic aneurysm; Abdominal aortic aneurysm; Endovascular procedures; Cone-beam computed tomography