Advanced Techniques in Thoracic Endovascular Aortic Repair: Chimneys/Periscopes, Fenestrated Endografts, and Branched Devices

Ramsey Al-Hakim, Ryan Schenning

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Thoracic endovascular aortic repair (TEVAR) is a rapidly growing and improving technique for the management of thoracic aortic aneurysms, dissections, and traumatic aortic injury. These disease processes were previously treated exclusively by surgery, but TEVAR has substantially improved patient outcomes including reduced mortality, reduced paraplegia rate, and shorter hospital and/or intensive care unit stay compared to open surgery. TEVAR was initially isolated to the descending thoracic aorta, but the advent of advanced techniques has extended the scope to well beyond the left subclavian artery and into Zone 0. Recent techniques include chimney grafts, periscope grafts, in situ fenestrations, and physician modified grafts. In addition, commercial branched aortic devices are currently on trial and will likely vastly extend the off-the-shelf capabilities of TEVAR for aortic arch disease. This paper reviews the data, concepts, and technical aspects of current advanced TEVAR techniques, as well as ongoing clinical trials for thoracic branched aortic devices.

Original languageEnglish (US)
Pages (from-to)146-155
Number of pages10
JournalTechniques in Vascular and Interventional Radiology
Volume21
Issue number3
DOIs
StatePublished - Sep 1 2018

Keywords

  • branched devices
  • chimney
  • fenestration
  • periscope
  • TEVAR

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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