Update in the Management of Non-traumatic Thoracoabdominal Vascular Emergencies

The incidence of new thoracoabdominal aortic aneurysms is increasing. Enhanced awareness combined with improved diagnostic imaging modalities has led to an increased diagnosis of thoracoabdominal aneurysms. With the current trend in population aging, more and more elderly patients will be diagnosed, and proper clinical management will be required. Patients with TAAA have a high prevalence of significant comorbid conditions which may decrease their long-term survival and increase their perioperative mortality and morbidity. Thus, it is important to know the natural history of TAAA in order to make the proper decision on operative indications. Further problems come from the complications of endovascular treatment in dissected patients. Very often it happens that patients with type B dissection are treated with thoracic endografting. The late expansion of the aorta can lead to an urgent situation for the onset of thoracic pain in the reperfused false lumen of the aorta is difficult to manage.