Current status of endovascular treatment for thoracoabdominal aortic aneurysms.
Surg Today
; 50(11): 1343-1352, 2020 Nov.
Article
en En
| MEDLINE
| ID: mdl-31776776
ABSTRACT
Open surgical repair (OSR) for thoracoabdominal aortic aneurysms (TAAAs) is maximally invasive and associated with high rates of operative mortality and perioperative complications including spinal cord ischemia (SCI), despite improvements in surgical techniques and perioperative care. Elderly patients, patients with a history of aortic surgery, and patients with severe comorbidities are often considered ineligible for this surgery and endovascular treatment may be their only treatment option. Total endovascular aneurysm repair (t-EVAR) without debranching surgery does not require thoracotomy and laparotomy and could improve the outcomes of these patients. t-EVAR includes fenestrated EVAR (f-EVAR), multi-branched EVAR (b-EVAR), and physician-modified fenestration endograft (PMFG). Although these techniques have achieved lower mortality rates than OSR, there are concerns about perioperative complications including limb ischemia, SCI, and long-term outcomes such as endograft migration and endoleaks (ELs). This article provides an overview of available endovascular devices for TAAAs and reviews the short and mid-term results of t-EVAR, as well as alternative options.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Aneurisma de la Aorta Torácica
/
Aneurisma de la Aorta Abdominal
/
Procedimientos Endovasculares
Tipo de estudio:
Diagnostic_studies
Límite:
Humans
Idioma:
En
Revista:
Surg Today
Año:
2020
Tipo del documento:
Article
País de afiliación:
Japón