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Semin intervent Radiol 2007; 24(2): 197-205
DOI: 10.1055/s-2007-980043
Copyright © 2007 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Endovascular Treatment of Atherosclerotic and Other Thoracic Aortic Aneurysms

Rossella Fattori1 , Vincenzo Russo1
  • 1Cardiothoracovascular Department, Cardiovascular Radiology Unit, University Hospital S. Orsola, Bologna, Italy
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Publication History

Publication Date:
12 June 2007 (online)

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ABSTRACT

The incidence of thoracic aortic aneurysms (TAAs) is increasing with the present rate of occurrence at 10.9 cases per 100,000 people per year. The estimated 5-year risk of rupture of a TAA with a diameter between 4 and 5.9 cm is 16%, but it rises to 31% for aneurysms ≥ 6 cm. Despite increasing awareness of the importance of early diagnosis and treatment options, there are no clear guidelines available at the time of writing. Nor is there any clear evidence for specific pharmacological treatment able to resolve or delay the disease progression. Endovascular treatment (EVT), proposed as an alternative to surgery, has been considered a therapeutic innovation, especially because it is minimally invasive, which allows treatment even in high surgical risk patients. Vascular imaging is crucial for patient selection, endoprosthesis choice, and planning of the treatment because not all aneurysms are suitable. Early and midterm results are encouraging, but long-term results are necessary to definitively assess reliability of stent-graft materials and improvement in patient survival. In the choice between surgical or endovascular repair of TAAs, many factors must be considered, including the clinical situation, comorbidities, anatomy, choice of equipment, and last, but not less important, experience of the clinical team.

KEYWORDS

Thoracic aortic aneurysm - endovascular treatment and follow-up

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Rossella FattoriM.D. 

Cardiothoracovascular Department, Cardiovascular Radiology Unit, University Hospital S. Orsola

Padiglione 21, Via Massarenti 9, 40138 Bologna, Italy

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