Moulakakis KG, Karaolanis G, Antonopoulos CN, Kakisis J, Klonaris C, Preventza O, Coselli JS, Geroulakos G. Open repair of thoracoabdominal aortic aneurysms in experienced centers. J Vasc Surg. 2018
....Despite the advances in open surgical techniques, the morbidity and mortality of the technique continue to remain considerable. Despite the focus on mortality and spinal cord ischemia, respiratory complications, permanent postoperative renal dialysis, stroke rate, and cardiac events also affect the outcome. The estimated trend of lower mortality in high-volume centers suggests that perhaps this type of service should be provided in a few reference centers that have an established record and experience in the management of these patients.....
Do you angree? Only 4-5 centers around the world have an accumulated experience to demonstrate an improved outcome in these patients. How can be all patients treated? The cost effectiveness of this strategy ?