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Area of Science:

  • Vascular Surgery
  • Medical Device Technology
  • Cardiovascular Research

Background:

  • Thoracic endovascular aortic repair (TEVAR) is a primary treatment for various thoracic aortic diseases.
  • Conditions include traumatic injury, aortic dissection, intramural hematoma, and penetrating ulcers.

Purpose of the Study:

  • Analyze the evolution of thoracic stent graft devices.
  • Review current FDA-approved TEVAR devices.
  • Discuss future technological advancements in TEVAR.

Main Methods:

  • Historical review of TEVAR device development.
  • Discussion of four currently available TEVAR devices: GORE® TAG®, Medtronic Navion™, Bolton RELAY®, and Cook Zenith® Alpha™.
  • Examination of features, applications, and future advancements.

Main Results:

  • Early TEVAR grafts faced limitations: large delivery systems, need for rapid pacing, "wind socking," and migration.
  • Current devices feature novel solutions like adjustable deployment (GORE® TAG®), low-profile systems (Navion™, RELAY®), and specialized designs (Zenith® Alpha™ for dissections).
  • Modern TEVAR devices have expanded applicability and reduced anatomical limitations.

Conclusions:

  • TEVAR technology has evolved to address previous technical challenges.
  • Current devices offer enhanced accuracy and broader applicability for diverse thoracic aortic pathologies.