Long-term survival after open repair and thoracic endovascular aortic repair for descending thoracic aortic aneurysms.

Thoracic endovascular aortic repair (TEVAR) for descending thoracic aortic aneurysms (DTAs) was first reported by Dake et al1 in 1994. The advent of TEVAR was clinically relevant because open DTA repair had long been associated with operative mortality rates ranging from 5% to 7% at centers of excellence2,3 to as high as 20% to 22% in real-world practice.4,5 The favorable results6 of TEVAR with nearly 75% reduction in operative mortality in early industrysponsored device trials led to US Food and Drug Administration approval for first commercial use in 2005 and subsequent device approvals in 2008.7,8 The operative mortality and morbidity benefits of TEVAR highlighted by numerous single-center reports,9–11 device registries,12,13 and device trials6–8 have led to widespread public and surgeon acceptance of this less invasive modality for the management of DTA in contemporary practice. As such, TEVAR has supplanted open surgical repair in the majority of patients with DTA.14,15