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
...agnosis...
...considered at low or intermediate...
...onsidered at high risk for symptom...
...or elective TEVAR cases, we sugges...
...s being considered, we recommend f...
...outine use of three-dimensional centerli...
...rast-enhanced MRA for preoperative planning f...
...travascular ultrasound (IVUS) use in TEVAR...
...re 1. Zones of the thorac...
...assification of the aortic arch...
Treatment
...atment...
...ertension is a modifiable risk factor fo...
...end interventions for smoking cessation in...
...n patients who could undergo either techniqu...
...d TEVAR in asymptomatic patients with a...
...g higher aortic diameter thresholds for...
...use of the dynamic nature of isolated intramura...
...d TEVAR in patients with IMH or penet...
...st TEVAR in selected cases of asymptoma...
...ggest TEVAR for symptomatic mycotic...
...creasing perfusion pressure through contr...
...ommend prophylactic cerebrospinal fluid (CSF) drai...
...lective TEVAR of a TAA where coverage of the...
...or patients in whom the anatomy to be...
...th acute thoracic emergencies, where TEVAR is...
...eprocedural TEVAR planning to include si...
...nonionic, hypo-osmolar contrast material with at...
...on the patient’s corporal density and...
...st the use of on-table mapping software opti...
...se the risk of atheroembolization, we recomm...
...ommend minimizing the dwelling time of la...
...ommend pre-emptive superior mesenteric...
...anticipation of high risk for CA terri...
If an open approach for access is u...
...using ultrasound guidance for percutaneous access...
We recommend that percutaneous access for TEVA...
...end the use of iliac conduits or direct...
...hat endoconduits to facilitate access fo...
...commend TEVAR over open repair for the...
...mmend contrast-enhanced CT scanning at on...