Descending thoracic aortic aneurysm: surgical approach and treatment using the adjuncts cerebrospinal fluid drainage and distal aortic perfusion

Endovascular Repair of Thoracic Aortic Emergencies

“…Recent reports present 30-day mortality rates of 15%-20%. Only highly specialized centers have reported mortality rates of between 25% and 30% after open repair of rDTAA (Jonker et al, 2010;Estrera et al, 2001). A recent comparative study by Patel and colleagues showed a 30-day mortality of 11.4% after TEVAR compared with 26.5% after open repair of ruptured thoracic aortic dissections and aneurysms (Patel et al, 2009).…”

Surgical Management of Descending Thoracic Aortic Disease: Open and Endovascular Approaches

“…3,4 Recent literature suggests a significant improvement in the mortality rate (4% to 9%) and incidence of paraplegia (3%) for descending thoracic aortic resections for thoracic aortic aneurysms (TAAs) at high-volume aortic centers. 5,6 Despite these improvements in outcomes with open repair, a less invasive approach is quite appealing, especially in older patients and in patients with significant concomitant comorbid diseases, many of whom would be unsuitable candidates for conventional open repair.…”

What should we do against delayed onset paraplegia following TEVAR?

“…Because endovascular treatment, compared to conventional surgery, is associated with a decrease in hospital mortality and postoperative morbidity, the use of stent-grafts has already changed the treatment of lesions of the descending thoracic aorta, and endovascular repair has been an alternative to traditional repair. Endovascular treatment was also expected to potentially reduce the incidence of ischemic spinal cord injury; however, the rate was reported to be 0-12 % [9][10][11], which is comparable to that of surgical series (2.7-13.8 %) [12,13].…”