Stent-graft repair in acute and chronic diseases of the thoracic aorta.

Thoracic aortic endografting has demonstrated encouraging mid-term results and attracts growing acceptance as a valuable treatment option for chronic aneurysmal disease. The emerging role of endovascular strategies for management of acute thoracic aortic pathologies is even more exciting considering the sobering results of open repair. Although it is accepted that patients at high risk for open surgery will benefit from endovascular strategies, the exact role of stent-graft interventions remains to be defined as the medical community awaits solid long-term data and better devices. While some indications and scenarios such as acute type B dissection with associated malperfusion syndrome or imminent aortic rupture have shown to benefit from stent-graft treatment, other scenarios are less settled. The current paper discusses both the established and emerging indications, as well as technical and anatomical aspects of this fascinating therapeutic option.