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Review paper
Published online: 2022-04-04
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Thoracic endovascular aortic repair: Current evidence and challenges

Andrzej Juraszek1, Martin Czerny1, Bartosz Rylski1
DOI: 10.33963/KP.a2022.0093
·
Pubmed: 35380010
Affiliations
  1. Department of Cardiovascular Surgery, University Heart Centre Freiburg, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Germany

open access

Online first
Review
Published online: 2022-04-04

Abstract

In 1987 Nikolay Volodos performed the world’s first endovascular treatment of aortic aneurysms. Endovascular technology has progressed significantly since then. There are now many thoracic endovascular aortic repair (TEVAR) systems commercially available. Applying them, we can treat many pathologies: aneurysms, dissections, aortic ruptures, and penetrating aortic ulcers. However, TEVAR technology still has its limitations, namely the risk of a retrograde type A dissection, the issue of precise landing in the distal landing zone, and the risk of air embolism and paraplegia. Furthermore, there are no appropriate stentgrafts widely available to treat acute dissections. Those being used are designed for aneurysms, not for dissections. As a result, there are currently several challenges facing the future TEVAR surgical community, such as the need to develop new and more precise systems with retrograde deployment for the distal landing zone, as well as to introduce flexible stentgrafts to treat dissections. The endo-Bentall is being developed as an alternative treatment method for acute type-A aortic dissection.

Abstract

In 1987 Nikolay Volodos performed the world’s first endovascular treatment of aortic aneurysms. Endovascular technology has progressed significantly since then. There are now many thoracic endovascular aortic repair (TEVAR) systems commercially available. Applying them, we can treat many pathologies: aneurysms, dissections, aortic ruptures, and penetrating aortic ulcers. However, TEVAR technology still has its limitations, namely the risk of a retrograde type A dissection, the issue of precise landing in the distal landing zone, and the risk of air embolism and paraplegia. Furthermore, there are no appropriate stentgrafts widely available to treat acute dissections. Those being used are designed for aneurysms, not for dissections. As a result, there are currently several challenges facing the future TEVAR surgical community, such as the need to develop new and more precise systems with retrograde deployment for the distal landing zone, as well as to introduce flexible stentgrafts to treat dissections. The endo-Bentall is being developed as an alternative treatment method for acute type-A aortic dissection.

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Keywords

thoracic aortic pathologies, thoracic endovascular repair

About this article
Title

Thoracic endovascular aortic repair: Current evidence and challenges

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Online first

Article type

Review paper

Published online

2022-04-04

Page views

70

Article views/downloads

111

DOI

10.33963/KP.a2022.0093

Pubmed

35380010

Keywords

thoracic aortic pathologies
thoracic endovascular repair

Authors

Andrzej Juraszek
Martin Czerny
Bartosz Rylski

References (42)
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