TY - JOUR
T1 - Advanced Techniques in Thoracic Endovascular Aortic Repair
T2 - Chimneys/Periscopes, Fenestrated Endografts, and Branched Devices
AU - Al-Hakim, Ramsey
AU - Schenning, Ryan
N1 - Publisher Copyright:
© 2018
PY - 2018/9
Y1 - 2018/9
N2 - 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.
AB - 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.
KW - TEVAR
KW - branched devices
KW - chimney
KW - fenestration
KW - periscope
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U2 - 10.1053/j.tvir.2018.06.004
DO - 10.1053/j.tvir.2018.06.004
M3 - Article
C2 - 30497549
AN - SCOPUS:85049301168
SN - 1089-2516
VL - 21
SP - 146
EP - 155
JO - Techniques in Vascular and Interventional Radiology
JF - Techniques in Vascular and Interventional Radiology
IS - 3
ER -