The evolving options for endovascular repair of complex aortic aneurysms. Foreword.

摘要

Treatment of aortic aneurysms has been revolutionized by the introduction of endovascular aortic aneurysm repair (EVAR). Level I evidence has confirmed the superiority of EVAR compared with open surgical repair by reducing several short-term outcome measures, including periproce-dural mortality, morbidity, blood loss, time of mechanical ventilation, and hospital stay. EVAR has been incorporated in most centers as the primary method of treatment in patients with infrarenal and thoracic aneurysms who have suitable anatomy. One of the basic principles that should be followed to achieve successful endovascular exclusion is the proper selection of healthy aorta for the proximal and distal landing zones of the stent graft. Given that infrarenal aneurysms represent the simplest form of aortic aneurysm, it is logical to assume that the benefits of EVAR would pale when the technique is applied to more complex aneurysm anatomy such as thoracoabdominal or aortic arch aneurysms.