Similar to how an Endoluminal Graft (ELG) is used to repair an abdominal aortic aneurysm, an endovascular graft can be implanted in the thoracic aorta to repair a thoracic aortic aneurysm. Click on the video clip to see how a graft is implanted to repair a thoracic aortic aneurysm.

What is a Thoracic Aortic Aneurysm?
A thoracic aortic aneurysm (TAA) is the dilation - thinning and ballooning, or bulging out - of the thoracic aorta. The aorta is the largest artery in the body, and it carries blood from the heart to branches leading to the arms, neck and head, abdomen and legs. The thoracic aorta is the portion of the aorta that is in the chest region and above the abdomen. If left untreated, a TAA can rupture with life-threatening results.



What causes an aneurysm to form?
An aneurysm may be caused or aggravated by disease (such as atherosclerosis or hypertension), injury, or an abnormality present at birth.

What dangers do aneurysms present?
The danger from an aneurysm is that it will continue to bulge and may burst. When an aneurysm in a large blood vessel bursts, a person could bleed to death.

How are aneurysms diagnosed?
In addition to a complete medical history and physical examination, diagnostic procedures for an aneurysm may include any, or a combination of, the following:

• computed tomography scan (also called a CT or CAT scan) - a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays. A CT scan can show the diameter of the thoracic aorta and reveal aneurysms.
• magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.
• echocardiogram (also known as echo) - a procedure that evaluates the structure and function of the heart by using sound waves recorded on an electronic sensor that produce a moving picture of the heart and heart valves.

For more information on each of these, as well as other diagnostic and surgical tests, refer to St. John’s Mercy Medical Center website.


What is an endovascular graft and how is it used to repair a TAA?
An ELG, also referred to as a stent, is an implantable tube composed of a combination of synthetic material and metal. It is inserted through an artery in the groin and is positioned inside the abdominal aorta at the site of the aneurysm. X-ray and ultrasound technologies projected on to a television monitor are used to create a map for the physician to locate the aneurysm.

How is the ELG procedure done?
A graft is an implantable device that is intended to seal off the aneurysm by relining the diseased aorta to make an open path for blood to flow. This minimally invasive procedure involves a small incision in the groin where the graft (which is compressed into a delivery device) is inserted and guided up into the aorta at the location of the aneurysm. The graft is then deployed, or opened up, to exclude the aneurysm. X-ray and ultrasound technologies projected on to a television monitor are used to create a map for the physician to locate the aneurysm.

If a stent is not used to treat a thoracic aortic aneurysm, what is the alternative?
If not treated with a stent, a thoracic aortic aneurysm is repaired through open surgery. The surgeon must make an incision in the chest and replace the diseased portion of the aorta with a synthetic graft, or tube. The graft is sewn into place with sutures. This procedure is performed while the patient is under general anesthesia.

What is the comparison of results & recovery: open surgical repair vs. stenting?
Results from open surgical repairs and stenting are very comparable. Both procedures have proven to be safe and effective, and current studies have shown outcomes for each to be rather similar. It is possible, however, that patients undergoing the open surgical procedure may have a longer recovery period due to the more invasive nature of the procedure.