Technical Tips for Endovascular Repair for Thoracic Aortic Aneurysm: TEVAR

Abstract

Aneurysms of the thoracic aorta are a life-threatening disease. While open aortic repair has been a standard procedure, thoracic endovascular aortic repair (TEVAR) has gained acceptance as an alternative for high-risk patients. The recent release of the PMDA-approved stent-grafts for thoracic aortic aneurysms has facilitated the widespread use of TEVAR in Japan because of its lower mortality and morbidity based on its lower invasiveness. Furthermore, hybrid TEVAR for aortic arch aneurysms or thoracoabdominal aortic aneurysms expands the treatment choices for patients. We describe here some particular technical tips in terms of avoiding unfavorable events such as endoleak and distal embolism. We also discuss advanced techniques such as TEVAR for aortic dissection and in-situ fenestration with case presentation.