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Arch Hellen Med, 26(2), March-April 2009, 179-194


Current treatment of descending thoracic aortic aneurysms

Department of Vascular Surgery, University of Milan, Policlinico San Donato, Milan, Italy

Vascular diseases occur very often in Greece, as in all countries of the western world, and their incidence is expected to increase as life expectancy increases. The incidence of thoracic aortic aneurysms is calculated at 5.9 for 100,000 population, and descending thoracic aortic aneurysm disease affects 1 in 1,000 elderly persons. Recently, significant improvement in the management of descending thoracic aortic aneurysms has been achieved. Anatomic studies in primates and particularly in human cadavers have elucidated the specific anatomy of the vasculature of the spinal cord, including the anatomy and the role of the anterior spinal artery, and its relationship with the great anterior radiculomedullary artery, the so-called artery of Adamkiewicz. Various strategies have been elaborated for the prevention of spinal cord injury and for reducing the need for open surgical treatment. Additionally, endovascular treatment of the disease has further reduced perioperative morbidity and mortality, while continuous improvements in endoprosthetic material are expected to improve the outcome even more. The aim of this study was to review the literature on the most recent progress in the management of descending thoracic aortic aneurysms. The management of the more complex thoracoabdominal aneurysms, and those that involve the aortic arch or left aortic hemiarch, are beyond the purpose of this review.

Key words: Adamkiewicz artery, Anterior spinal artery, Descending thoracic aortic aneurysm, Endovascular treatment, Surgical treatment.

© Archives of Hellenic Medicine