Endovascular Treatment of Various Aortic Pathologies: Review of the Latest Data and Technologies

Abstract

The technologies and innovations applicable to endovascular treatment for complex aortic pathologies have progressed rapidly over the last two decades. Although the initial outcomes of an endovascular aortic repair have been excellent, as long-term data became available, complications including endoleaks, endograft migration, and endograft infection have become apparent and are of concern. Previously, the indication for endovascular therapy was restricted to descending thoracic aortic aneurysms and abdominal aortic aneurysms. However, its indication has expanded along with the improvement of techniques and devices, and currently, it has become possible to treat pararenal aortic aneurysms and Crawford type 4 thoracoabdominal aortic aneurysm (TAAA) using the off-the-shelf devices. Additionally, custom-made devices allow for the treatment of arch or more extensive TAAAs. Endovascular treatment is applied not only to aneurysms but also to acute/chronic dissections. However, long-term outcomes are still unclear. This article provides an overview of available devices and the results of endovascular treatment for various aortic pathologies.

The emergency medical team's role in initial treatment and transport of patients with abdominal aortic aneurysm rupture

“…U pojedinim zdravstvenim sistemima gde postoje jasno definisani protokoli za zbrinjavanje RAAA, njihovom implementacijom u kliničkoj praksi, mortalitet bolesnika u prvih 30 dana iznosi 18%. Nasuprot tome, u sistemima u kojima ne postoje protokoli, mortalitet u navedenom periodu iznosi 32% [27,28]. Slično ovome, zaključak EUROASPIRE V studije je da upadljiva varijabilnost u zbrinjavanju pacijenata između različitih zemalja i centara, može biti umanjena adekvatnom edukacijom i medicinskih profesionalaca i pacijenata o neohodnosti promene stila života osoba koje su u povećanom riziku za razvoj ovog akutnog stanja [29].…”