Indications for Thoracic EndoVascular Aortic Repair (TEVAR): A Brief Review

Abstract

The utility of Thoracic EndoVascular Aortic Repair (TEVAR) continues to progress at a very rapid rate. Initially implemented for the treatment of thoracic aortic aneurysms, TEVAR has evolved to treat a variety of aortic pathologies and reduce overall morbidity and mortality rates compared with traditional open surgical repair.Given the rapidly evolving nature of endovascular thoracic intervention, we hereby briefly review the current literature on the evolving applications of TEVAR.TEVAR continues to rapidly evolve and is being applied to a growing number of aortic pathologies. Given the perioperative, short- and mid-term morbidity and mortality rates, TEVAR is quickly surpassing traditional open surgical intervention as the ideal procedure for patients undergoing intervention of the descending thoracic aorta and applicability to ascending and arch pathologies is being explored. However, as more data becomes available TEVAR may be associated with higher rates of reoperative requirements. Data remains limited on the long-term efficacy of the intervention and should continue to be investigated.

Prolonged survival of a patient with aortogastric fistula treated with combined surgery and endovascular stent placement: A case report

“…Present case had two significant challenges. First, albeit a useful technique for aortic aneurysms, implantation of an endograft with thoracic endovascular aortic repair was not approved for use in humans in 1999 [ 9 ]. In the present case, a thin-walled, 30-mm woven Dacron graft was arranged with a self-expandable stent, which allowed the control of aneurysm.…”

Massive Hemoptysis Caused by an Aortobronchial Fistula Related to Pedicle Screw Impingement

“…TEVAR has been widely accepted as the optimal treatment for a spectrum of thoracic aortic pathology including aortobronchial fistula due to lower operative mortality, less complications, and better quality of life than open surgical repair. 2,5,17,18 Generally, regional or local anesthesia has already been successfully applied for managing TEVAR, and each has its own advantages and disadvantages. 19 Although high quality data regarding the use of local anesthesia versus general anesthesia during the performance of TEVAR are lacking and are typically physician/ hospital dependent, 20 pTEVAR with local anesthesia over the inguinal area has been well documented as a less invasive and effective approach and may provide additional benefits, such as mean blood pressure stability and early recognition of neurologic complications.…”

Endovaskuläre Verfahren für die aszendierende Aorta

“…15-20 % größer als die Aorta in der Landezone sein. Dieses sogenannte Stentgraft-Oversizing garantiert die adäquate Abdichtung der Landezone und verhindert die Stentgraftmigration [3].…”