The most relevant unmet needs in endovascular management of descending thoracic aorta
| Autor: | Carla Blanco Amil, Laura Capoccia, Xavier Yugueros, Vincent Riambau, Gaspar Mestres |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Endoleak Computed Tomography Angiography Aortic Diseases Aorta Thoracic 030204 cardiovascular system & hematology Prosthesis Design Aortography Unmet needs Blood Vessel Prosthesis Implantation 03 medical and health sciences 0302 clinical medicine Foreign-Body Migration Risk Factors Blood vessel prosthesis medicine.artery medicine Humans Thoracic aorta aortic disease thoracic aorta endovascular repair Endovascular treatment Intensive care medicine Computed tomography angiography Aortic Segment Aorta medicine.diagnostic_test business.industry Endovascular Procedures Hemodynamics General Medicine Blood Vessel Prosthesis Prosthesis Failure Treatment Outcome 030228 respiratory system Cardiothoracic surgery Surgery Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Journal of Cardiovascular Surgery. 60 |
| ISSN: | 1827-191X 0021-9509 |
| DOI: | 10.23736/s0021-9509.19.10911-1 |
| Popis: | Endovascular repair of descending thoracic aorta (DTA) is considered as first interventional option for most part of the aortic disorders. However, many unmet needs and issues are still limiting its applicability. One of the major limitations is related to the existing gaps in evidence. Clear and robust evidence is still needed in many aspects of the management of DTA pathologies. In numerous clinical scenarios, adequate trials are lacking. Besides those gaps in evidence, it is well recognized that thoracic endografting (TEVAR) is technically evolving in order to overcome technical and device-related complications and limitations. We can deploy endografts in any aortic segment: in the descending, in the ascending, in the arch, even preserving aortic branches. Nevertheless, from the pure technical point of view, current generations of endografts still need more development and improvement. Durability remains the major concern for any endovascular treatment, and thoracic endografting is not an exception. As Galenus said, the physician is only nature's assistant, thoracic endograft should also follow the natural anatomy instead of fighting against it. We will focus the following pages on the graft conformability and compliance, both related to durability and safety of thoracic endografting. We will review the current knowledge and concerns associated with the anatomical and hemodynamic modifications induced by the thoracic endograft strength, stiffness and straightness and their implications for the future thoracic endograft designs. |
| Databáze: | OpenAIRE |
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