Thoracic Endovascular Aneurysm Repair
Key Points
Key Points
- Thoracic aortic diseases, including disease of the descending thoracic aorta (DTA), are significant causes of death in the United States.
- Thoracic endovascular aneurysm repair (TEVAR) should be the primary method of repair in both the elective and emergent setting based on improved short- and mid-term mortality, as well as decreased morbidity.
Diagnosis
Diag...
...nsidered at low or intermediate ri...
...tients considered at high risk for symptom...
...ive TEVAR cases, we suggest assessm...
...s being considered, we recommend fine-cut (≤...
...utine use of three-dimensional centerline re...
...suggest contrast-enhanced MRA for preoperative pl...
We recommend intravascular ultrasoun...
...re 1. Zones of the thoracic aorta...
...e 2. Classification of the aortic arch...
Treatment
...Trea...
...ypertension is a modifiable risk factor...
...mmend interventions for smoking ce...
...could undergo either technique (within the crite...
...mmend TEVAR in asymptomatic patients wi...
...e suggest using higher aortic diame...
...e of the dynamic nature of isolated intramur...
...TEVAR in patients with IMH or penetrating aortic u...
...TEVAR in selected cases of asymptomatic P...
...t TEVAR for symptomatic mycotic/infect...
...increasing perfusion pressure through c...
...d prophylactic cerebrospinal fluid (CSF) dr...
...TEVAR of a TAA where coverage of the...
...n whom the anatomy to be treated compromises perfu...
...ients with acute thoracic emergencies,...
...d preprocedural TEVAR planning to includ...
...ecommend nonionic, hypo-osmolar contras...
...the patient’s corporal density and...
...suggest the use of on-table mapping sof...
...se the risk of atheroembolization, we...
...end minimizing the dwelling time of la...
...pre-emptive superior mesenteric artery...
...anticipation of high risk for CA territory isc...
...oach for access is used, we recommend trans...
...using ultrasound guidance for percutaneous...
...at percutaneous access for TEVAR is safe and an...
...commend the use of iliac conduits or direct iliac...
...endoconduits to facilitate access for TEVAR are a...
...nd TEVAR over open repair for the tr...
...nd contrast-enhanced CT scanning at one month and...