Thoracic Aortic Diseases

Thoracic aortic pathologies include large spectrum of diseases including aneurysm, dissection, and rupture with extremely high rate of mortality. In the last 50 years, open surgery has been considered the treatment of choice consisting in replacing of unhealthy aortic tract with synthetic graft. This surgery (e.g., DeBakey–Coley graft) carries several risks of intra- and post-operative complications such as brain infarction, spinal cord ischemia, and paraplegia. Since mid-1990s, endovascular repair was introduced for treatment of thoracic aortic aneurysm. This technique is based on introducing a covered stent-graft into the aorta through a femoral access, excluding the diseased tract; it provides better outcomes in terms of intra and early post-operative complications and overall mortality, and it is currently considered the technique of choice among the majority of referring hospitals. In this section, some aspects of the aortic pathologies and treatment will be discussed; because of large diffusion of endovascular treatment, keypoints about the planning on imaging will be discussed.