New results with the Zenith graft in the treatment of aortic aneurysms.

Aneurysmal disease of the arterial vasculature has been reported since ancient times. Regarding aneurysms of the aorta, a steady progress has been made ranging from making such pathology amenable to surgical treatment to making the procedure much less invasive. There have been a number of stent grafts, introduced by different companies, used to exclude different segments of the aneurysmal aorta and the Zenith devices are one of them. The safety and efficacy of these devices to exclude infrarenal and descending thoracic aortic aneurysms has been well documented. The early and late complications associated with these procedures and the methods used to manage such complications have also been elucidated in different publications. In dealing with pararenal and thoracoabdominal aneurysms, the need to ensure patency of the visceral vessels while still repairing the aorta to healthy tissue must be considered. Strategies involving fenestrations and side-arm branches have evolved extending the ability to treat the entire aorta with an endovascular approach. Challenges exist including the inherent tortuosity and mobility of the aortic arch, close approximation of the supra-aortic vessels, small or multiple renal vessels, the commonly noted arcuate ligament compression of the celiac artery, but great strides have been made and virtually all pathologies have been addressed. The desire for smaller delivery systems has spurred interest in low-profile devices. This manuscript is intended to address the latest developments and clinical results for endovascular grafting of the aorta.