Open versus endovascular treatment of thoracoabdominal aortic aneurysms: parallel and controversia
10.3760/cma.j.cn112434-20221117-00355
- VernacularTitle:胸腹主动脉瘤的开放与腔内治疗：并行与争议
- Author:
Zehui CAO
1
;
Qiliang ZHANG
;
Shiqun WU
;
Debin LIU
Author Information
1. 兰州大学第二医院心外科，兰州 730000
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2023;39(10):634-640
- CountryChina
- Language:Chinese
-
Abstract:
Open surgery is currently the gold standard for the treatment of thoracoabdominal aortic aneurysm(TAAA), while endovascular aortic repair(EVAR) has also been widely carried out. Because it involves important branches supplying internal organs, the technical system for treating TAAA is particularly complex. However, with the advent of newer, low-cost, flexible stent systems, total endovascular repair techniques have become more feasible and attractive. For young and low-risk patients, the choice of open or endovascular treatment remains controversial. Despite the advantages of a minimally invasive procedure, EVAR carries a greater risk of spinal cord injury and may require secondary endovascular intervention to repair endoleak when its unique complication occurs, and the long-term durability after EVAR is not clear. This article reviews the open and endovascular treatment of TAAA, introduces the development of open surgery and endovascular repair, the advantages and disadvantages of various types of stents, and discusses how to select a more suitable surgical method for patients, providing clinicians with a treatment reference.
