Endovascular repair of lesions involving the descending thoracic aorta

Abstract

Endovascular treatment of vascular lesions involving the descending thoracic aorta can be safely performed with low morbidity in high-risk patients. Endovascular repair may become an attractive alternative for the treatment of a wide range of pathology along this vascular territory.

Endovascular stent-grafting of anastomotic pseudoaneurysms following thoracic aortic surgery

“…1 Many promising results of endovascular repair on arteriosclerotic thoracic aortic aneurysms have been reported. 2,3 It is reasonable, then, that the endovascular repair is being considered as an essential treatment for anastomotic pseudoaneurysm. In fact, good results of endovascular repair for anastomotic pseudoaneurysm following an abdominal aortic surgery 4 and surgical repair of congenital aortic coarctation 5 were reported Fig.…”

Endovascular repair of traumatic thoracic aortic disruptions with “stacked” abdominal endograft extension cuffs

“…13 Although small aortic diameter may promote collapse, other variables such as poor apposition of the endograft to the aortic wall, acute aortic arch angulation, and other anatomic factors may also play a causative role in endoprosthesis collapse, although this remains to be proven. 13,14 Because of these concerns, many surgeons are reluctant to use the TAG device in patients with aortas measuring Ͻ23 mm in diameter.…”

“…The wisest course of action appears to be to add an extra cuff if any doubt of treatment length is present. Two late pseudo-aneurysms also occurred (one due to infection from a pulmonary abscess at 4 months and one at the distal attachment site at 14), for an overall complication rate of 13%.…”

Thoracic endovascular aortic repair of aortobronchial fistulas

“…Anatomic requirements, sizing of endografts, and follow-up were as previously described. 25 A search of the MEDLINE database was conducted from January 1990 to January 2008 through PUBMED using the keywords aortobronchial, aorto-bronchial, aortopulmonary, aorto-pulmonary, aortotracheal, and aortobronchopulmonary. The search was limited to English-language literature and the treatment of adult patients (aged Ն18 years).…”