Renowned French Physician Discussed Important Contraindications Of Treating Thoracic Aortic Aneurysms (TAA) By Endografts

Main Category: Cardiovascular / Cardiology
Article Date: 24 Nov 2008 - 9:00 PDT

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Endovascular exclusion of complex aortic aneurysms with fenestrated and branched endografts is now routinely performed in many centers.

Dr. Stephan Haulon, M.D., Professor at the Université de Lille, Hôpital Cardiologique-CHRU, Lille, France, outlined a number of important contraindications to this procedure.

First, since there is not long term data available to support its use in young and/or healthy patients, these patients should not be offered this procedure.

Second, even though the endovascular approach is minimally invasive compared to open surgery (absence of aortic cross clamping, laparotomy and thoracotomy), the inability to reimplant intercostal arteries is a major concern as this can result in paraplegia especially in the setting where collateral flow is poor.

Third, patients with chronic dissections and the development of thoracoabdominal aneurysmal dilation are frequently poor candidates for an endovascular approach.

Fourth, and this may change with time, patients with aortic rupture or other complications requiring emergent operation are not candidates for a fenestrated endograft since it takes 6 to 8 weeks to manufacture the specific endograft.

As Dr. Haulon pointed out, future developments include the design of branched and fenestrated endografts that will adapt to a large majority of anatomical features and facilitate repair in a larger group of patients.

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Source
Pauline T. Mayer
www.ptmhcm.com