Objective: The endoluminal stent-graft represents an attractive and a less invasive technique in the treatment of the various diseases of the descending thoracic aorta. The purpose of this study was to evaluate the endovascular stent-graft Talent in the treatment of various localized diseases of the descending thoracic aorta.Methods: Over a 3-year period, thoracic endograft Talent were placed in 40 patients with a high surgical risk, presenting localized lesions of the descending thoracic aorta: Degenerative aneurysm (n=13), Acute traumatic rupture (n=11), Acute Stanford type B aortic dissection (n=6), False aneurysm (n=7) and Penetrating atherosclerotic ulcer (n=3). 15 patients (37.5 %) were treated as emergencies. The feasibility of endovascular treatment and sizing of the aorta and stent-grafts were determined pre-operatively by Magnetic Resonance Angiography (MRA) and intra-operative angiography. Immediate and mid term technical and clinical success were assessed by clinical and MRA follow-up.Results: Endovascular treatment was completed successfully in all 40 patients with no conversion to open repair or intra-operative mortality. The mean operative time was 37.5+/-7 minutes. The overall 30-day mortality rate was 10 % (n=4) all in emergency cases, causes not related to the endograft. The primary technical success was 92.5 %. The mean follow-up period was 15 +/-5 months. The survival rate was 95% (n=35). Diminution of the aneurismal size was observed in 47.5% (n=19).Conclusion. Endovascular treatment of the various localized diseases of the descending thoracic aorta is a promising, feasible, alternative technique to open surgery in well selected patients.