Thoracic Endovascular Aneurysm Repair

Publication Date: July 3, 2020

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...

...ients considered at low or intermediate risk...


...nsidered at high risk for symptomatic TAA...


For elective TEVAR cases, we suggest a...


...AR is being considered, we recommend fine...


...ecommend routine use of three-dimensional c...


We suggest contrast-enhanced MRA for...


...ecommend intravascular ultrasound (IVUS) use...


...re 1. Zones of the thoracic aorta


...2. Classification of the aortic arc...


Treatment

...eatment...

...hypertension is a modifiable risk facto...


...erventions for smoking cessation in patien...


...ients who could undergo either tec...


...recommend TEVAR in asymptomatic patie...


...t using higher aortic diameter thre...


...dynamic nature of isolated intramural h...


...commend TEVAR in patients with IMH or pene...


...TEVAR in selected cases of asymptomatic PAU...


...R for symptomatic mycotic/infected TAA...


...commend increasing perfusion pressu...


...e recommend prophylactic cerebrospinal fluid (CS...


...ective TEVAR of a TAA where coverage of the...


...n whom the anatomy to be treated c...


...nts with acute thoracic emergencies, where TEVAR i...


...commend preprocedural TEVAR planning to inc...


...onionic, hypo-osmolar contrast material...


...pending on the patient’s corporal density and th...


...se of on-table mapping software options on fixe...


...crease the risk of atheroembolizatio...


...end minimizing the dwelling time of la...


...e-emptive superior mesenteric artery...


In anticipation of high risk for CA territo...


If an open approach for access is used, we...


...mend using ultrasound guidance for percutaneous...


...that percutaneous access for TEVAR is safe...


...mmend the use of iliac conduits or direc...


...ggest that endoconduits to facilitate access...


...commend TEVAR over open repair for the treat...


...mend contrast-enhanced CT scanning at one mo...