During the last two decades, there has been a shift toward endovascular repair of patients withthoracic aortic diseases. Four groups of patients with different clinical characteristics and background, have benefited from the endovascular repair of the thoracic aorta. Patients with aneurysmatic disease, patients with aortic dissection or penetrating ulcer, patients with connective tissue disorders and patients with blunt thoracic aortic injury (BTAI) caused mainly by road accidents.
There are several problems and specific concerns associated with TEVAR in the young patient population. The impact of aortic growth on graft anatomy in the long-term is not known.The concern for graft migration as aortic remodeling occurs with growth remains a serious concern, and a close long-term follow-up surveillance protocol is necessary. Another specific concern is the hemodynamic impact exerted by a vascular prosthesis implanted in the descending thoracic aorta, which has been proved more severe than implanting the endograft in the abdominal aorta
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