INTRODUCTION: The authors describe their experience with the implantation of endovascular self-expanding stent-grafts for the treatment of descending aortic thoracic diseases. METHOD: From June 1996 to April 2002, 14 endovascular self-expanding stent-grafts were implanted, 10 in acute type B dissections, 3 in atherosclerotic aneurysms and 1 in a penetrating aortic ulcer. The patient's ages varied between 43 and 77 years (mean = 63.3 years). In the majority of cases the procedure was performed under general anesthesia. The delivery of the stent-graft endoprostheses was performed using the trans-femoral system. RESULTS: There was one death on the sixth postoperative day by pulmonary thromboembolism. One patient was operated on for the implantation of an endovascular self-expanding stent-graft through the aortic arch under deep hypothermia and circulatory arrest, and died eight months after operation. All the survivors were well and imaging studies showed adequate correction of the aortic disease. CONCLUSION: Preliminary results suggest that this technique will contribute to improve surgical results in the treatment of descending thoracic aortic diseases.