The impact of new technologies in endovascular repair of thoraco-abdominal aortic aneurysm

BACKGROUND: Thoraco-abdominal aortic aneurysms (TAAAs) are considered a challenging clinical scenarios. Despite modern intra/perioperative adjuncts, T A A A open repair has not negligible mortality and morbidity rates also in high volume centres. New technologies with the endovascular approach can reduce the complication rate of TAAA treatment. A i m of present work is to evaluate the outcome of endovascular treatment of TAAA in a single centre. METHODS: A retrospective evaluation of the endovascular T A A A treatment in a single center from 2010 to 2017 was performed. The technical success, mortality, morbidity and visceral vessels patency were evaluated at 30-day and during the follow-up. RESULTS: In the study period, an overall of 80 TAAAs (urgent and elective cases) were treated in our centre by FB-EVAR . Five cases were ruptured TAAAs (6.3%). Custom made and off the shelf device were used in 57 (71.2%) and 23 (28.8%) cases for an overall of 289 target visceral vessels (3.6/patient). Technical Success was 92.5%. The postoperative target visceral vessels patency rate was 97.0%. Spinal cord ischemia was 6%. The 30-day mortality was 3.8%. A t a mean follow-up was 18.5- SD 15.0 months the overall survival was 96%, 83%, and 70% at 6, 12 and 24 months. CONCLUSIONS: The total endovascular TAAA repair is technical demanding, time-consuming, and requires a dedicated and advanced knowl¬ edge in the endovascular materials, technologies and a dedicated team for planning. However the results are promising and associated with low mortality and morbidity.