COMMENTARY: Marching Closer Toward a Convergence of Technologies for Thoracic Aortic Endografting and Percutaneous Heart Valve Therapies.

摘要

As the paradigm of endografting for complex thoracic aortic diseases evolves, much attention has been focused on optimizing the technical design of the various stent-grafts. Since 2005, when the first thoracic aortic endovascular prosthesis was approved by the US Food and Drug Administration, manufacturers of the 3 US-approved thoracic aortic stent-grafts have developed second-generation technologies that have incrementally improved upon certain design elements to address limitations and improve clinical performance. In parallel, clinicians have continued to push the boundaries of which disease states and aortic anatomies the thoracic aortic endoprostheses are capable of treating . An untold number of different aortic pathologies have been treated utilizing thoracic aortic stent-grafts in an off-label fashion beyond the currently approved indication of degenerative atherosclerotic aneurysms. Finally, an assorted number of combined surgical and endovascular procedures ("hybrid") have been developed to further extend the clinical use of non-branched thoracic aortic stent-grafts.