Descending thoracic and thoracoabdominal aortic aneurysms.

Correspondence and requests for reprints to James I. Fann, MD, Department of Cardiothoracic Surgery, Falk Cardiovascular Research Center, Stanford University Medical School, Stanford, California 94305-5247, USA. Tel: þ1 650 858 3917; fax: þ1 650 723 7110; e-mail: [email protected] Introduction Since the incidence of thoracic aortic aneurysms are over five cases per 100 000 person-years, patients with this entity are not infrequently evaluated by the physician in the outpatient or hospital setting [1]. A descending thoracic aortic aneurysm is defined as involving any portion of the thoracic aorta distal to the left subclavian artery and extending to above the diaphragm; thoracoabdominal aortic aneurysms are more extensive with the distal portion involving all or part of the abdominal aorta. The main goal of the diagnosis and treatment is to prevent aneurysm rupture, which is the most feared and devastating complication. Historically, techniques to treat patients with aneurysms of the aorta or peripheral arteries included ligation proximal to the aneurysm, excision and over-sewing of the neck of the aneurysm, placement of wire into the sac to effect thrombosis, aneurysm wrapping with an external support, and endoaneurysmorrhaphy.