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J Thorac Cardiovasc Surg 2004;127:620-621
© 2004 The American Association for Thoracic Surgery

Editorial

Nihil nocere on the rocky road to endovascular stent-graft treatment

Christoph A. Nienaber, MDa,*, Raimund Erbel, MDb, Hüseyin Ince, MDa

a Division of Cardiology at the University Hospital Rostock, Department of Internal Medicine, Rostock, Germany
b GHS Essen, Germany

Received for publication November 19, 2003; accepted for publication November 24, 2003.

* Address for reprints: Christoph A. Nienaber, MD, FACC, FESC, Division of Cardiology, University Hospital of Rostock, Ernst-Heydemann-Str. 6, 18057 Rostock , Germany
christoph.nienaber@med.uni-rostock.de

The first 20% of the full text of this article appears below.


See related editorial on page 664.

 

Aneurysms of the thoracic aorta represent a potentially life-threatening situation, with the risk of rupture increasing with diameter. Surgical resection and interposition of vascular prostheses (Dacron or polytetrafluoroethylene* ) have long been considered the standard treatment, despite the substantial risk of severe complications from surgical trauma. Regardless of the great strides in the past decades to improve technique and management, perioperative mortality and morbidity remained high.1-3 As a consequence of demographic changes in the Western world, the afflicted population is of increasing age and associated with a variety of comorbidities portending an inherent risk and explaining in part the sobering surgical outcomes. Moreover, perioperative complications ranging from paraplegia to transient renal failure contribute to prolonged hospitalization and high costs.4 As a revolutionary alternative,5 the concept of use of an endovascular stent graft in a patient with a thoracic aortic aneurysm (TAA) emerged a decade ago propelled by the desire (1) to avoid surgical risks by use of a nonsurgical approach and (2) to induce reconstructive remodeling of the diseased aorta by initiating a natural healing process through exclusion and depressurization of the aneurysmal sac. Although initial reports on the endovascular stent-graft strategy were encouraging,6-8 randomized data on . . . [Full Text of this Article]


Related Article

Midterm results of endovascular repair of descending thoracic aortic aneurysms with first-generation stent grafts
Philippe Demers, D. Craig Miller, R. Scott Mitchell, Stephen T. Kee, Daniel Sze, Mahmood K. Razavi, and Michael D. Dake
J. Thorac. Cardiovasc. Surg. 2004 127: 664-673. [Abstract] [Full Text] [PDF]





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