Percutaneous interventional approaches to diseases of the aorta.

Diseases of the aorta are prevalent in the Western world. Pathophysiology is influenced by hypertension, atherosclerosis, and genetic factors. The rupture of an aortic aneurysm or the dissection of a hematoma into the aortic wall causes significant mortality in this country. Physicians have long wrestled with therapies to prevent this fatal natural history. It was not until the surgical insertion of aortic grafts in the 20th century that effective therapy was developed. However, surgical mortality and morbidity still remain quite significant in the higher risk population in which these procedures often must be performed. During the 1990s, techniques and devices have been developed which allow placement of endovascular grafts into the aorta percutaneously, without traditional surgery. Two recently FDA-approved devices require a team approach for optimal deployment and care. In the initial experience, these endovascular devices appear to offer the promise of effective treatment with low procedural complications.