Thoracic endovascular aneurysm repair

A thoracic endovascular aneurysm repair (TEVAR) is a type of endovascular aneurysm repair that involves the thoracic aorta.

Indications

It is a commonly applied treatment strategy for the a various thoracic aortic pathologies inclusive of both

• type A and type B thoracic aortic dissections
• penetrating atherosclerotic ulcers of thoracic aorta
• thoracic aortic aneurysm
• thoracic aortic injury
  • thoracic aortic pseudoaneurysm

Contraindciations

Recognized contraindications include

• unfavorable anatomy
  • inadequate proximal or distal seal zones
  • tortuosity
  • lack of vascular access options or extremes of aortic diameter.
• placement into infected regions

Landing zones

An understanding of landing zones is useful for a reporting radiologist in pre-operative and post-operative assessment.

There zones are often numbered as

• zone 0: from distal to the coronary ostia  to proximal edge of innominate artery
• zone 1: from distal to innominate artery to proximal and involving the left common carotid artery
• zone 2: from distal to the left common carotid artery to proximal and involving the left subclavian artery
• zone 3: from distal margin of the left subclavian artery to 2 cm distal to the left subclavian artery
• zone 4: from 2 cm distal to the left subclavian artery to midpoint of the descending thoracic aorta
• zone 5: from midpoint of descending thoracic aorta to proximal margin of the celiac artery
• zone 6: from celiac artery origin to proximal margin of the superior mesenteric artery
• zone 7: from superior mesenteric artery to remainder of suprarenal aorta

Siehe auch:

• Adamkiewicz-Arterie
• endovascular aneurysm repair (EVAR)
• präoperative Identifikation der Adamkiewicz-Arterie

und weiter:

• endovaskuläre Therapie des Bauchaortenaneurysmas