A thoracic aortic aneurysm is defined as a localized enlargement that has a diameter that exceeds 1.5 times the normal expected diameter of the aorta at that location. Aneurysms of the thoracic aorta affect approximately 15-20,000 Americans each year, resulting in nearly 6,000 deaths.
•Family history of aneurismal disease •History of prior arterial aneurysm substantially increases risk of developing additional aneurysm •Personal history of atherosclerotic disease including cardiovascular or peripheral vascular disease •Smoking •Hypertension Signs and Symptoms The majority of patients with aneurysms of the aorta are asymptomatic; however, common symptoms associated with aortic aneurysm disease are: •Chest, flank, back or abdominal pain or cramping •Voice change, chronic cough or hoarseness (resulting from aneurysm causing traction on recurrent laryngeal nerve) •Distal atheroemboli to legs, feet or toes •Pulsatile mass in abdomen Treatment Traditionally thoracic aortic aneurysms have been treated by resection of the aneurysm and replacement of the aneurismal aorta with a prosthetic graft. The invasiveness of this procedure is often too much for patients to tolerate, especially given the other major co-morbidities such as diabetes, peripheral vascular disease, chronic obstructive pulmonary disease and coronary artery disease that often affect these patients. Hence, operative mortality rates range from 8-20% and major morbidity rates are as high as 20% with conventional open surgery. The advent of endovascular stent grafts has revolutionized the treatment of patients with thoracic aortic aneurysms allowing operative mortality rates as low as 1%. The minimally invasive nature of the endovascular approach has also resulted in a drastic reduction in the recovery period with most patients requiring only a 3-day hospital stay (compared with an average 10-day hospital stay with conventional open surgery).