Joseph Coselli

Joseph Coselli is particularly associated with open repair of thoracoabdominal aortic aneurysms, which affect the aorta across the chest and abdomen. He has led a high-volume aortic surgery program at Baylor College of Medicine and Baylor St. Luke's Medical Center in Houston.

The Crawford classification divides thoracoabdominal aortic aneurysms into anatomical extents based on how much of the thoracic and abdominal aorta is involved. Surgeons use the classification when discussing operative complexity and risks to organs, the spinal cord, and the kidneys.

His international reputation is rooted primarily in complex open aortic reconstruction, including extensive thoracoabdominal repairs. Modern aortic centers may consider open, endovascular, or hybrid treatment according to anatomy, age, connective-tissue disease, and previous operations.

Thoracoabdominal repair can interrupt blood flow to arteries that help supply the spinal cord, creating a risk of paralysis. Protective strategies can include cerebrospinal-fluid drainage, careful blood-pressure management, reattachment of selected intercostal arteries, and staged restoration of circulation.