Endovascular Repair of Thoracic Aortic Aneurysms

  • Bradley B. Hill
  • Christopher K. Zarins
  • Thomas J. Fogarty


The detection of thoracic aortic aneurysms has increased since the early 1970s along with the overall increasing prevalence of aneurysmal disease in our aging population. Frequently, patients with thoracic aneurysms have additional serious medical co-morbidities that make them high risk surgical candidates. The results of endovascular repair of abdominal aortic aneurysms indicate that stent-graft techniques, compared to conventional repair, are associated with decreased morbidity and mortality rates, shorter hospitalization, and a more rapid, less painful recovery from the patient’s perspective. Thoracotomy for repair of thoracic aortic aneurysms is associated with an even higher risk of serious morbidity and mortality than conventional repair of abdominal aortic aneurysms particularly in patients with significant cardiopulmonary disease. Recognition of this problem has spurred an initiative to develop less invasive approaches to repairing descending thoracic aortic aneurysms. The adaptation of stent-graft technology to the treatment of thoracic aneurysms is limited because most aneurysms that involve the descending thoracic aorta extend into the abdominal viscerorenal aortic segment. In select patients, endovascular repair of thoracic aortic aneurysms offers the possibility of reducing morbidity and mortality by avoiding thoracotomy.


Magnetic Resonance Angiography Aortic Aneurysm Thoracic Aorta Abdominal Aortic Aneurysm Common Iliac Artery 
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  1. 1.
    Coselli JS, de Figueiredo LF: Natural history of descending and thoracoabdominal aortic 13. aneurysms, J Card Surg 12 (suppl): 285–289, 1997.PubMedCrossRefGoogle Scholar
  2. 2.
    Dake MD, Miller DC, Semba CP et al: Translu- 14. minai placement of endovascular stent-grafts for the treatment of descending thoracic aortic aneurysms, N Engl J Med 331: 1729–1734, 1994.PubMedCrossRefGoogle Scholar
  3. 3.
    Moreno-Cabral CE, Miller DC, Mitchell RS et 15. al: Degenerative and atherosclerotic aneurysms of the thoracic aorta: determinants of early and late surgical outcome, J Thorac Cardiovasc Surg 88: 1020–1032, 1984. 16.Google Scholar
  4. 4.
    Semba CP, Mitchell RS, Miller DC et al: Thoracic aortic aneurysm repair with endovascular stentgrafts, Vasc Med 2: 25–30, 1997.Google Scholar
  5. 5.
    Semba CP, Kato N, Kee ST et al: Acute rupture 17. of the descending thoracic aorta: repair with use of endovascular stent-grafts, J Vasc Intervent Radiol 8: 337–342, 1997.CrossRefGoogle Scholar
  6. 6.
    Kato N, Dake MD, Miller DC et al: Traumatic thoracic aortic aneurysm: treatment with endovascular stent-grafts, Radiology 205: 657–662, 1997.PubMedGoogle Scholar
  7. 7.
    Scharrer-Pamler R, Gorich J, Orend KH et al: Emergent endoluminal repair of delayed abdominal aortic rupture after blunt trauma, J Endovasc Surg 5: 134–137, 1998.PubMedCrossRefGoogle Scholar
  8. 8.
    Deshpande A, Mossop P, Gurry J et al: Treatment of traumatic false aneurysm of the thoracic aorta with endoluminal grafts, J Endovasc Surg 5: 120–125, 1998.PubMedCrossRefGoogle Scholar
  9. 9.
    Desgranges P, Mialhe C, Cavillon A et al: Endovascular repair of posttraumatic thoracic pseudoaneurysm with a stent graft, AJR 169: 1743–1745, 1997.PubMedGoogle Scholar
  10. 10.
    Semba CP, Sakai T, Slonim SM et al: Mycotic aneurysms of the thoracic aorta: repair with use of endovascular stent-grafts, J Vasc Intervent Radiol 9: 33–40, 1998.CrossRefGoogle Scholar
  11. 11.
    Moon MR, Mitchell RS, Dake MD et al: Simultaneous abdominal aortic replacement and thoracic stent-graft placement for multilevel aortic disease, J Vasc Surg 25: 332–340, 1997.PubMedCrossRefGoogle Scholar
  12. 12.
    Ehrlich M, Grabenwoeger M, Cartes-Zumelzu F et al: Endovascular stent graft repair for aneurysms on the descending thoracic aorta, Ann Thorac Surg 66: 19–24, 1998.PubMedCrossRefGoogle Scholar
  13. 13.
    Mitchell RS, Miller DC, Dake MD. Stent-graft repair of thoracic aortic aneurysms, Semin Vasc Surg 10: 257–271, 1997.PubMedGoogle Scholar
  14. 14.
    Ishimaru S, Kawaguchi S, Koizumi N et al: Preliminary report on prediction of spinal cord ischemia in endovascular stent graft repair of thoracic aortic aneursym by retrievable stent graft, J Thorac Surg 115: 811–818, 1998.CrossRefGoogle Scholar
  15. 15.
    Golzarian J, Dussaussois L, Abada HT et al: Helical CT of aorta after endoluminal stent-graft therapy: value of biphasic acquisition, AJR 171: 329–331, 1998.PubMedGoogle Scholar
  16. 16.
    Rozenblit A, Marin ML, Veith FJ et al: Endovascular repair of abdominal aortic aneurysm: value of postoperative follow-up with helical CT, AJR 165: 1473–1479, 1995.PubMedGoogle Scholar
  17. 17.
    Kato N, Semba CP, Dake MD: Embolization of perigraft leaks after endovascular stent-graft treatment of aortic aneurysms, J Vasc Intervent Radiol 7: 805–811, 1996.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1999

Authors and Affiliations

  • Bradley B. Hill
  • Christopher K. Zarins
  • Thomas J. Fogarty

There are no affiliations available

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