TEVARThoracic Endovascular Aneurysm Repair
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After right common carotid-to-left common carotid arterial bypass with an 8 mm polytetrafluoroethylene (PTFE) graft, TEVAR with zone 1 landing was performed through the right femoral artery by surgical dissection.
There is likely to be a trend towards aggressive TEVAR management in patients with BTAI.
Like the abdominal version, the thoracic system can be used during de novo (initial) TEVAR procedures to enhance an endograft's inherent fixation and sealing mechanisms.
This case illustrates some of the obstacles many surgeons and facilities still face when trying to perform TEVAR.
The chimney technique with selective or bail-out conditions was used to extend the proximal landing zone in TEVAR.
TEVAR can be used in select patients to repair type B dissections and thoracic aneurysms.
The TAA HeliFX will allow surgeons greater control over the fixation and positioning of TEVAR devices and has promise for significantly reducing the susceptibility of TEVAR to the devastating consequences of late failure resulting from migration or aortic dilatation.
sup][1],[2] Although several controversies continue to exist regarding the optimal treatment strategy for type B-AD, the recent interdisciplinary expert consensus document suggests that TEVAR should be used for complicated cases with suitable anatomy to decrease the mortality and morbidity of open surgery, whereas medical management with close follow-up is the best strategy for uncomplicated type B-AD.
The recent launch, in mid-2008 of Cook's Zenith TX2 and Medtronic's Talent in the US coupled with the opening of Japanese market to TEVAR devices fueled growth as many patients not eligible for open surgery entered the endovascular patient pool.
According to the company, Zenith Alpha Thoracic will allow physicians to treat more patients with TEVAR (thoracic endovascular aortic repair) because of its lower-profile introduction system and broad range of sizes.
As a result, these physicians were already familiar with TEVAR and quickly switched to the newly approved devices.