European Society for Vascular Surgery (ESVS) 2026 Clinical Practice Guidelines on the Management of Descending Thoracic and Thoraco-Abdominal Aortic Diseases. - 2025
European Society for Vascular Surgery (ESVS) 2026 Clinical Practice Guidelines on the Management of Descending Thoracic and Thoraco-Abdominal Aortic Diseases.
Wanhainen, Anders; Gombert, Alexander; Antoniou, George Aet al.
2025 • In European Journal of Vascular and Endovascular Surgery
[en] OBJECTIVE: The European Society for Vascular Surgery (ESVS) has developed clinical practice guidelines for the care of patients with descending thoracic and thoraco-abdominal aortic pathologies, in succession to the 2017 version, with the aim of assisting physicians and patients in selecting the best management strategy. METHODS: The guideline is based on scientific evidence complemented with expert opinion on the matter. By summarising and evaluating the best available evidence, recommendations for the evaluation and treatment of patients have been formulated. The recommendations are graded according to the ESVS grading system, where the strength (class) of each recommendation is graded from I to III and the level of evidence from A to C. RESULTS: One hundred and twenty-nine recommendations have been issued across the following main topics: (1) acute thoracic aortic syndrome; (2) chronic type B aortic dissection; (3) descending thoracic and thoraco-abdominal aortic aneurysms; (4) ruptured descending thoracic and thoraco-abdominal aortic aneurysms; and (5) blunt thoracic aortic injury. Additional topics include genetic aortopathy, floating thrombus and shaggy aorta, inflammatory aortitis, mycotic aortic aneurysms, coarctation of the aorta, aberrant subclavian artery, and service standards such as surgical volume, imaging, risk assessment, and optimisation. Special considerations include pregnancy, left subclavian artery revascularisation, spinal cord ischaemia, stroke prevention, vascular access, and the patient's perspective. A final chapter addresses unresolved issues. CONCLUSION: These clinical practice guidelines provide comprehensive, up to date advice to clinicians and patients on the management of descending thoracic and thoraco-abdominal aortic pathologies.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Wanhainen, Anders; Uppsala and Umeå, Sweden. Electronic address: anders.wanhainen@uu.se.
Gombert, Alexander; Aachen, Germany.
Antoniou, George A; Manchester, UK.
Fidalgo Domingos, Liliana A; Faro, Portugal.
Gouveia E Melo, Ryan; Lisbon, Portugal.
Grabenwöger, Martin; Vienna, Austria.
Haulon, Stephan; Paris, France.
Katsargyris, Athanasios; Athens, Greece and Nuremberg, Germany.
Kölbel, Tilo; Hamburg, Germany.
Loftus, Ian M; London, UK.
Mani, Kevin; Uppsala, Sweden.
Mees, Barend M E; Maastricht, the Netherlands.
Melissano, Germano; Milan, Italy.
Pedro, Luís Mendes; Lisbon, Portugal.
Prendes, Carlota F; Uppsala, Sweden.
Spanos, Konstantinos; Larissa, Greece.
Tsilimparis, Nikolaos; Munich, Germany.
Van Herzeele, Isabelle; Ghent, Belgium.
Venermo, Maarit; Helsinki, Finland.
Verhoeven, Eric L G; Nuremberg, Germany.
Gonçalves, Frederico Bastos; Lisbon, Portugal.
Björck, Martin; Uppsala, Sweden, Tartu, Estonia, and Trondheim, Norway.
Chakfé, Nabil; Strasbourg, France.
Coscas, Raphaël; Boulogne-Billancourt, France.
Dias, Nuno V; Malmö and Lund, Sweden.
Lepidi, Sandro; Trieste, Italy.
Resch, Timothy A; Copenhagen, Denmark.
Ricco, Jean-Baptiste; Poitiers, France and Toulouse, France.
Trimarchi, Santi; Milan, Italy.
Tulamo, Riikka; Helsinki, Finland.
Twine, Christopher P; Bristol, UK.
Beck, Adam W; Birmingham, AL, USA.
Bicknell, Colin D; London, UK.
Kolh, Philippe ; Université de Liège - ULiège > Département des sciences biomédicales et précliniques > Biochimie et physiologie générales, humaines et pathologiques ; Liège, Belgium.
European Society for Vascular Surgery (ESVS) 2026 Clinical Practice Guidelines on the Management of Descending Thoracic and Thoraco-Abdominal Aortic Diseases.
Publication date :
23 December 2025
Journal title :
European Journal of Vascular and Endovascular Surgery
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