| Abstract [eng] |
Thoracoabdominal aortic aneurysm (TAAA) is a rare disease, however it is still clinically important since mortality is very high if untreated. Open repair is the gold standard of TAAA repair. It is a major operation and many patients are not ideal candidates for it. It led to the development of less invasive endovascular repair. FEVAR and BEVAR are now used as important treatment options, especially in patients with high operative risk. This narrative literature review analyzed the current evidence on endovascular repair of TAAA. PubMed, Cochrane Library, and ClinicalTrials.gov were searched. Studies published between 2010 and 2025 were included. Clinical trials, registry studies, and major comparative studies were considered. In most analyzed publications, technical success of FEVAR and BEVAR was high, usually above 90%. Compared with open repair, endovascular repair often had lower perioperative morbidity. Patients in endovascular group usually had a shorter hospital stay. SCI, renal complications, and reinterventions rates remain relevant. Long-term studies showed that aneurysm exclusion was effective and aneurysm-related mortality was low. Although, overall mortality was still high. The available evidence supports endovascular repair as an effective option in selected patients with TAAA. However, most evidence is still observational and non-randomized. More long-term prospective studies and randomized studies are needed. These studies should address comparison with other treatment strategies, long-term outcomes, measures for complications prevention. |
