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Published on: July 7, 2013
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Endovascular repair of ascending aortic pathologies in patients unfit for open surgery: case series and literature
Marco Ferraresi1, Maria Katsarou1, Alessandro Carlo Luigi Molinari1
1Division of Vascular Surgery, Cardio-Thoracic-Vascular Department, Alessandro Manzoni Hospital, Lecco, Italy.
Journal of Vascular Surgery Cases and Innovative Techniques
|March 21, 2024
Summary
Ascending thoracic endovascular aortic repair (TEVAR) is a feasible option for patients unfit for open surgery. This case series shows promising results, but standardization and device improvements are needed for wider adoption.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Interventional Cardiology
Background:
- Open surgical repair is the gold standard for ascending aortic disease.
- A significant portion of patients are unsuitable for open surgery.
- Ascending thoracic endovascular aortic repair (TEVAR) is an emerging alternative.
Purpose of the Study:
- To describe the technical feasibility and clinical outcomes of ascending TEVAR in high-risk patients.
- To evaluate the use of standard endografts for ascending aortic pathologies.
Main Methods:
- Three patients unfit for open surgery underwent ascending TEVAR.
- Techniques included supra-aortic trunk debranching and use of abdominal aortic cuffs.
- Standard, commercially available endografts were utilized.
Main Results:
- All three patients survived the 2-year follow-up period.
- Complications included a minor stroke and an inguinal hematoma.
- One patient required reintervention for embolic occlusion after successful initial repair and subsequent open surgery.
Conclusions:
- Ascending TEVAR is technically feasible and clinically appropriate for selected patients.
- Further research is needed to standardize techniques and optimize device efficacy.
- An "aortic team" approach and improved graft design may enhance future outcomes.
