Emergent stent-graft treatment for rupture

Abstract

It is not too surprising, given the lower prevalence of thoracic aortic aneurysms (TAA) as compared with abdominal aortic aneurysms (AAA), that development of endovascular devices for thoracic disease has lagged behind progress in the infrarenal area. Recently, published reports of decreased mortality associated with endovascular device implantation for ruptured AAAs have highlighted its potential advantage in emergent situations. The first reported use of an endovascular stent graft to treat a ruptured TAA was reported by Semba et al in 1997. Although the use of endovascular therapy to treat ruptured AAAs is gaining wider acceptance, its use in thoracic pathologies has been slow to develop in the United States, even though 20% of TAAs and nearly 50% of thoracic dissections present with rupture in the EUROSTAR registry. This may be a factor of relatively limited dissemination of technology. Examination of clinical trial enrollment shows that 10 sites in the United States account for approximately 50% of the cumulative implantations

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