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Long-Term Patency of Visceral Vessels After Thoracoabdominal Aortic Repair

  • Andrea KahlbergEmail author
  • Vincenzo Ardita
  • Angela M. R. Ferrante
  • Luca Bertoglio
  • Daniele Mascia
  • Domenico Baccellieri
  • Germano Melissano
  • Roberto Chiesa
Chapter

Abstract

Open repair of thoracoabdominal aortic aneurysms (TAAAs) is an extraordinary challenge for both vascular surgeons and patients. Consistent outcome data have been reported by high-volume centers with 30-day mortality rates lower than 10% and improved long-term survivals [1]. The development of devices and techniques have allowed total endovascular treatment of TAAA with fenestrated (FEVAR) or branched (BEVAR) endografts [2–6]. Early results are encouraging; a recent meta-analysis has reported a 30-day mortality rate of 8.6%, spinal cord ischemia in 17.3% of cases with permanent consequences in 4.9%, and renal failure in 25.4%. However, anatomic feasibility of BEVAR/FEVAR is still limited, manufacturing times for custom devices are lengthy, and open repair remains the only viable strategy in a number of specific conditions, such as emergency cases, infections, and patients affected by connective tissue disorders.

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Andrea Kahlberg
    • 1
    Email author
  • Vincenzo Ardita
    • 1
  • Angela M. R. Ferrante
    • 2
  • Luca Bertoglio
    • 1
  • Daniele Mascia
    • 1
  • Domenico Baccellieri
    • 3
  • Germano Melissano
    • 1
  • Roberto Chiesa
    • 4
  1. 1.Vascular SurgeryVita-Salute University School of Medicine, San Raffaele Scientific InstituteMilanItaly
  2. 2.Unit of Vascular SurgeryFondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro CuoreRomeItaly
  3. 3.Unit of Vascular SurgerySan Raffaele Scientific InstituteMilanItaly
  4. 4.Unit of Vascular SurgerySan Raffaele Scientific Institute, Vita-Salute UniversityMilanItaly

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