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Endovascular repair of the thoracic aorta

Authors
Grace J Wang, MD
Ronald M Fairman, MD
Section Editors
Emile R Mohler III, MD
Gabriel S Aldea, MD
John F Eidt, MD
Joseph L Mills, Sr, MD
Deputy Editor
Kathryn A Collins, MD, PhD, FACS

INTRODUCTION

Endovascular repair of the thoracic aorta, also referred to as thoracic endovascular aortic repair (TEVAR), refers to a minimally invasive approach that involves placing a stent-graft in the thoracic or thoracoabdominal aorta for the treatment of a variety of thoracic aortic pathologies. TEVAR was initially used to provide treatment to patients who were not considered to be surgical candidates, but it is now the preferred technique for treatment given the improved risk profile compared with open thoracic aortic surgery. In this topic review, we principally discuss endovascular repair of thoracic aortic aneurysm, but variations on the technique as it pertains to other thoracic pathologies are also briefly reviewed.

The indications for, preparation, and issues related to thoracic endograft placement, follow-up, and outcomes will be reviewed. Issues related to the management of thoracic aortic diseases that might be treated using thoracic endovascular stent-grafts are discussed separately. (See "Management of thoracic aortic aneurysm in adults" and "Management of acute aortic dissection" and "Blunt thoracic aortic injury" and "Overview of acute aortic syndromes".)

ANATOMIC CONSIDERATIONS

Aortic arch anatomy, extent of aortic arch disease (figure 1), and the available landing zones dictate the nature of endovascular repair.

"Normal" thoracic aortic diameter varies according to location within the aorta and also with age, gender, and body habitus [1-3]. Average normal diameters of the thoracic aorta identified on imaging (computed tomography, magnetic resonance) are given elsewhere. (See "Clinical manifestations and diagnosis of thoracic aortic aneurysm", section on 'Definition of TAA'.)

Aortic anatomy — The aorta originates immediately beyond the aortic valve and ascends initially, then it curves, forming the aortic arch, and descends caudally adjacent the spine. The ascending thoracic aorta gives off the coronary arteries, and the aortic arch branches are typically the brachiocephalic trunk (branches to the right common carotid and right subclavian arteries), left common carotid and left subclavian arteries; however, aortic arch anatomy can vary (figure 2). The descending thoracic aorta provides paired thoracic arteries (T1-T12) and continues through the hiatus of the diaphragm (figure 3A-B) to become the abdominal aorta, which extends retroperitoneally to its bifurcation into the common iliac arteries at the level of the fourth lumbar vertebra.

                                         

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Literature review current through: Nov 2016. | This topic last updated: Wed Sep 07 00:00:00 GMT+00:00 2016.
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References
Top
  1. Hiratzka LF, Bakris GL, Beckman JA, et al. 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with Thoracic Aortic Disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine. Circulation 2010; 121:e266.
  2. Devereux RB, de Simone G, Arnett DK, et al. Normal limits in relation to age, body size and gender of two-dimensional echocardiographic aortic root dimensions in persons ≥15 years of age. Am J Cardiol 2012; 110:1189.
  3. Rogers IS, Massaro JM, Truong QA, et al. Distribution, determinants, and normal reference values of thoracic and abdominal aortic diameters by computed tomography (from the Framingham Heart Study). Am J Cardiol 2013; 111:1510.
  4. Fillinger MF, Greenberg RK, McKinsey JF, et al. Reporting standards for thoracic endovascular aortic repair (TEVAR). J Vasc Surg 2010; 52:1022.
  5. Matsumura JS, Cambria RP, Dake MD, et al. International controlled clinical trial of thoracic endovascular aneurysm repair with the Zenith TX2 endovascular graft: 1-year results. J Vasc Surg 2008; 47:247.
  6. Makaroun MS, Dillavou ED, Wheatley GH, et al. Five-year results of endovascular treatment with the Gore TAG device compared with open repair of thoracic aortic aneurysms. J Vasc Surg 2008; 47:912.
  7. Makaroun MS, Dillavou ED, Kee ST, et al. Endovascular treatment of thoracic aortic aneurysms: results of the phase II multicenter trial of the GORE TAG thoracic endoprosthesis. J Vasc Surg 2005; 41:1.
  8. Bavaria JE, Appoo JJ, Makaroun MS, et al. Endovascular stent grafting versus open surgical repair of descending thoracic aortic aneurysms in low-risk patients: a multicenter comparative trial. J Thorac Cardiovasc Surg 2007; 133:369.
  9. Najibi S, Terramani TT, Weiss VJ, et al. Endoluminal versus open treatment of descending thoracic aortic aneurysms. J Vasc Surg 2002; 36:732.
  10. Stone DH, Brewster DC, Kwolek CJ, et al. Stent-graft versus open-surgical repair of the thoracic aorta: mid-term results. J Vasc Surg 2006; 44:1188.
  11. Grabenwöger M, Alfonso F, Bachet J, et al. Thoracic Endovascular Aortic Repair (TEVAR) for the treatment of aortic diseases: a position statement from the European Association for Cardio-Thoracic Surgery (EACTS) and the European Society of Cardiology (ESC), in collaboration with the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Eur J Cardiothorac Surg 2012; 42:17.
  12. Coady MA, Ikonomidis JS, Cheung AT, et al. Surgical management of descending thoracic aortic disease: open and endovascular approaches: a scientific statement from the American Heart Association. Circulation 2010; 121:2780.
  13. Greenberg RK, Lu Q, Roselli EE, et al. Contemporary analysis of descending thoracic and thoracoabdominal aneurysm repair: a comparison of endovascular and open techniques. Circulation 2008; 118:808.
  14. Walsh SR, Tang TY, Sadat U, et al. Endovascular stenting versus open surgery for thoracic aortic disease: systematic review and meta-analysis of perioperative results. J Vasc Surg 2008; 47:1094.
  15. Svensson LG, Crawford ES, Hess KR, et al. Experience with 1509 patients undergoing thoracoabdominal aortic operations. J Vasc Surg 1993; 17:357.
  16. Safi HJ, Winnerkvist A, Miller CC 3rd, et al. Effect of extended cross-clamp time during thoracoabdominal aortic aneurysm repair. Ann Thorac Surg 1998; 66:1204.
  17. Johnston KW, Rutherford RB, Tilson MD, et al. Suggested standards for reporting on arterial aneurysms. Subcommittee on Reporting Standards for Arterial Aneurysms, Ad Hoc Committee on Reporting Standards, Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery. J Vasc Surg 1991; 13:452.
  18. Creager MA, Belkin M, Bluth EI, et al. 2012 ACCF/AHA/ACR/SCAI/SIR/STS/SVM/SVN/SVS Key data elements and definitions for peripheral atherosclerotic vascular disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Clinical Data Standards (Writing Committee to develop Clinical Data Standards for peripheral atherosclerotic vascular disease). J Am Coll Cardiol 2012; 59:294.
  19. Huang YK, Ko PJ, Chen CL, et al. Therapeutic opinion on endovascular repair for mycotic aortic aneurysm. Ann Vasc Surg 2014; 28:579.
  20. Jia X, Dong YF, Liu XP, et al. Open and endovascular repair of primary mycotic aortic aneurysms: a 10-year single-center experience. J Endovasc Ther 2013; 20:305.
  21. Johnstone JK, Slaiby JM, Marcaccio EJ, et al. Endovascular repair of mycotic aneurysm of the descending thoracic aorta. Ann Vasc Surg 2013; 27:23.
  22. Naughton PA, Park MS, Morasch MD, et al. Emergent repair of acute thoracic aortic catastrophes: a comparative analysis. Arch Surg 2012; 147:243.
  23. Demetriades D, Velmahos GC, Scalea TM, et al. Operative repair or endovascular stent graft in blunt traumatic thoracic aortic injuries: results of an American Association for the Surgery of Trauma Multicenter Study. J Trauma 2008; 64:561.
  24. Xenos ES, Abedi NN, Davenport DL, et al. Meta-analysis of endovascular vs open repair for traumatic descending thoracic aortic rupture. J Vasc Surg 2008; 48:1343.
  25. Garcia-Toca M, Naughton PA, Matsumura JS, et al. Endovascular repair of blunt traumatic thoracic aortic injuries: seven-year single-center experience. Arch Surg 2010; 145:679.
  26. Kaya A, Heijmen RH, Overtoom TT, et al. Thoracic stent grafting for acute aortic pathology. Ann Thorac Surg 2006; 82:560.
  27. Duebener LF, Lorenzen P, Richardt G, et al. Emergency endovascular stent-grafting for life-threatening acute type B aortic dissections. Ann Thorac Surg 2004; 78:1261.
  28. Nienaber CA, Kische S, Rousseau H, et al. Endovascular repair of type B aortic dissection: long-term results of the randomized investigation of stent grafts in aortic dissection trial. Circ Cardiovasc Interv 2013; 6:407.
  29. Nienaber CA, Zannetti S, Barbieri B, et al. INvestigation of STEnt grafts in patients with type B Aortic Dissection: design of the INSTEAD trial--a prospective, multicenter, European randomized trial. Am Heart J 2005; 149:592.
  30. Brunkwall J, Lammer J, Verhoeven E, Taylor P. ADSORB: a study on the efficacy of endovascular grafting in uncomplicated acute dissection of the descending aorta. Eur J Vasc Endovasc Surg 2012; 44:31.
  31. Eggebrecht H, Baumgart D, Radecke K, et al. Aortoesophageal fistula secondary to stent-graft repair of the thoracic aorta. J Endovasc Ther 2004; 11:161.
  32. Ferrero E, Viazzo A, Ferri M, et al. Acute management of aortoesophageal fistula and tracheoesophageal fistula treated by thoracic endovascular aortic repair and esophageal endoprosthesis: a case misdiagnosed as esophageal cancer. Ann Vasc Surg 2011; 25:1142.e1.
  33. Canaud L, Ozdemir BA, Bee WW, et al. Thoracic endovascular aortic repair in management of aortoesophageal fistulas. J Vasc Surg 2014; 59:248.
  34. Canaud L, Alric P, Gandet T, et al. Open surgical secondary procedures after thoracic endovascular aortic repair. Eur J Vasc Endovasc Surg 2013; 46:667.
  35. Lin PH, El Sayed HF, Kougias P, et al. Endovascular repair of thoracic aortic disease: overview of current devices and clinical results. Vascular 2007; 15:179.
  36. Gawenda M, Brunkwall J. Comparison of CE approved TEVAR devices. J Cardiovasc Surg (Torino) 2010; 51:157.
  37. Nakatamari H, Ueda T, Ishioka F, et al. Discriminant analysis of native thoracic aortic curvature: risk prediction for endoleak formation after thoracic endovascular aortic repair. J Vasc Interv Radiol 2011; 22:974.
  38. Grobner T, Prischl FC. Patient characteristics and risk factors for nephrogenic systemic fibrosis following gadolinium exposure. Semin Dial 2008; 21:135.
  39. Kaladji A, Spear R, Hertault A, et al. Centerline is not as accurate as outer curvature length to estimate thoracic endograft length. Eur J Vasc Endovasc Surg 2013; 46:82.
  40. Müller-Eschner M, Rengier F, Partovi S, et al. Accuracy and variability of semiautomatic centerline analysis versus manual aortic measurement techniques for TEVAR. Eur J Vasc Endovasc Surg 2013; 45:241.
  41. Gasper WJ, Reilly LM, Rapp JH, et al. Assessing the anatomic applicability of the multibranched endovascular repair of thoracoabdominal aortic aneurysm technique. J Vasc Surg 2013; 57:1553.
  42. Kasirajan K, Dake MD, Lumsden A, et al. Incidence and outcomes after infolding or collapse of thoracic stent grafts. J Vasc Surg 2012; 55:652.
  43. Jonker FH, Schlosser FJ, Geirsson A, et al. Endograft collapse after thoracic endovascular aortic repair. J Endovasc Ther 2010; 17:725.
  44. Lee WA. Failure modes of thoracic endografts: Prevention and management. J Vasc Surg 2009; 49:792.
  45. Ueda T, Fleischmann D, Dake MD, et al. Incomplete endograft apposition to the aortic arch: bird-beak configuration increases risk of endoleak formation after thoracic endovascular aortic repair. Radiology 2010; 255:645.
  46. Smith TA, Gatens S, Andres M, et al. Hybrid repair of thoracoabdominal aortic aneurysms involving the visceral vessels: comparative analysis between number of vessels reconstructed, conduit, and gender. Ann Vasc Surg 2011; 25:64.
  47. Jakob H, Dohle DS, Piotrowski J, et al. Six-year experience with a hybrid stent graft prosthesis for extensive thoracic aortic disease: an interim balance. Eur J Cardiothorac Surg 2012; 42:1018.
  48. Greenberg RK, Lytle B. Endovascular repair of thoracoabdominal aneurysms. Circulation 2008; 117:2288.
  49. Leon LR Jr, Mills JL Sr, Jordan W, et al. The risks of celiac artery coverage during endoluminal repair of thoracic and thoracoabdominal aortic aneurysms. Vasc Endovascular Surg 2009; 43:51.
  50. Vaddineni SK, Taylor SM, Patterson MA, Jordan WD Jr. Outcome after celiac artery coverage during endovascular thoracic aortic aneurysm repair: preliminary results. J Vasc Surg 2007; 45:467.
  51. Jorna FH, Verhoeven EL, Bos WT, et al. Treatment of a ruptured thoracoabdominal aneurysm with a stent-graft covering the celiac axis. J Endovasc Ther 2006; 13:770.
  52. Canaud L, Ozdemir BA, Patterson BO, et al. Retrograde aortic dissection after thoracic endovascular aortic repair. Ann Surg 2014; 260:389.
  53. Sirignano P, Pranteda C, Capoccia L, et al. Retrograde type B aortic dissection as a complication of standard endovascular aortic repair. Ann Vasc Surg 2015; 29:127.e5.
  54. Xue Y, Sun L, Zheng J, et al. The chimney technique for preserving the left subclavian artery in thoracic endovascular aortic repair. Eur J Cardiothorac Surg 2015; 47:623.
  55. Zhu Y, Guo W, Liu X, et al. The single-centre experience of the supra-arch chimney technique in endovascular repair of type B aortic dissections. Eur J Vasc Endovasc Surg 2013; 45:633.
  56. Austermann M, Donas KP, Panuccio G, et al. Pararenal and thoracoabdominal aortic aneurysm repair with fenestrated and branched endografts: lessons learned and future directions. J Endovasc Ther 2011; 18:157.
  57. Cires G, Noll RE Jr, Albuquerque FC Jr, et al. Endovascular debranching of the aortic arch during thoracic endograft repair. J Vasc Surg 2011; 53:1485.
  58. Reilly LM, Rapp JH, Grenon SM, et al. Efficacy and durability of endovascular thoracoabdominal aortic aneurysm repair using the caudally directed cuff technique. J Vasc Surg 2012; 56:53.
  59. Hughes GC, Barfield ME, Shah AA, et al. Staged total abdominal debranching and thoracic endovascular aortic repair for thoracoabdominal aneurysm. J Vasc Surg 2012; 56:621.
  60. Shahverdyan R, Gawenda M, Brunkwall J. Triple-barrel graft as a novel strategy to preserve supra-aortic branches in arch-TEVAR procedures: clinical study and systematic review. Eur J Vasc Endovasc Surg 2013; 45:28.
  61. Bisdas T, Donas KP, Bosiers M, et al. Anatomical suitability of the T-branch stent-graft in patients with thoracoabdominal aortic aneurysms treated using custom-made multibranched endografts. J Endovasc Ther 2013; 20:672.
  62. Yuri K, Yokoi Y, Yamaguchi A, et al. Usefulness of fenestrated stent grafts for thoracic aortic aneurysms. Eur J Cardiothorac Surg 2013; 44:760.
  63. Verhoeven EL, Katsargyris A, Bekkema F, et al. Editor's Choice - Ten-year Experience with Endovascular Repair of Thoracoabdominal Aortic Aneurysms: Results from 166 Consecutive Patients. Eur J Vasc Endovasc Surg 2015; 49:524.
  64. Ricco JB, Forbes TL. Trans-Atlantic debate: Debate regarding the best surgical option for type IV thoracoabdominal aortic aneurysms. Eur J Vasc Endovasc Surg 2011; 42:1.
  65. Redlinger RE Jr, Ahanchi SS, Panneton JM. In situ laser fenestration during emergent thoracic endovascular aortic repair is an effective method for left subclavian artery revascularization. J Vasc Surg 2013; 58:1171.
  66. Tse LW, Lindsay TF, Roche-Nagle G, et al. Radiofrequency in situ fenestration for aortic arch vessels during thoracic endovascular repair. J Endovasc Ther 2015; 22:116.
  67. Bin Jabr A, Lindblad B, Dias N, et al. Efficacy and durability of the chimney graft technique in urgent and complex thoracic endovascular aortic repair. J Vasc Surg 2015; 61:886.
  68. Rehman SM, Vecht JA, Perera R, et al. How to manage the left subclavian artery during endovascular stenting of the thoracic aorta. Eur J Cardiothorac Surg 2011; 39:507.
  69. Feezor RJ, Martin TD, Hess PJ, et al. Risk factors for perioperative stroke during thoracic endovascular aortic repairs (TEVAR). J Endovasc Ther 2007; 14:568.
  70. Woo EY, Mcgarvey M, Jackson BM, et al. Spinal cord ischemia may be reduced via a novel technique of intercostal artery revascularization during open thoracoabdominal aneurysm repair. J Vasc Surg 2007; 46:421.
  71. Noor N, Sadat U, Hayes PD, et al. Management of the left subclavian artery during endovascular repair of the thoracic aorta. J Endovasc Ther 2008; 15:168.
  72. Saouti N, Hindori V, Morshuis WJ, Heijmen RH. Left subclavian artery revascularization as part of thoracic stent grafting. Eur J Cardiothorac Surg 2015; 47:120.
  73. Waterford SD, Chou D, Bombien R, et al. Left Subclavian Arterial Coverage and Stroke During Thoracic Aortic Endografting: A Systematic Review. Ann Thorac Surg 2016; 101:381.
  74. Dexter D, Maldonado TS. Left subclavian artery coverage during TEVAR: is revascularization necessary? J Cardiovasc Surg (Torino) 2012; 53:135.
  75. Szeto WY, Bavaria JE, Bowen FW, et al. The hybrid total arch repair: brachiocephalic bypass and concomitant endovascular aortic arch stent graft placement. J Card Surg 2007; 22:97.
  76. Zhou W, Reardon M, Peden EK, et al. Hybrid approach to complex thoracic aortic aneurysms in high-risk patients: surgical challenges and clinical outcomes. J Vasc Surg 2006; 44:688.
  77. Bergeron P, Mangialardi N, Costa P, et al. Great vessel management for endovascular exclusion of aortic arch aneurysms and dissections. Eur J Vasc Endovasc Surg 2006; 32:38.
  78. Chuter TA, Schneider DB, Reilly LM, et al. Modular branched stent graft for endovascular repair of aortic arch aneurysm and dissection. J Vasc Surg 2003; 38:859.
  79. Jim J, Caputo FJ, Sanchez LA. Intentional coverage of the celiac artery during thoracic endovascular aortic repair. J Vasc Surg 2013; 58:270.
  80. Riesenman PJ, Reeves JG, Kasirajan K. Endovascular management of a ruptured thoracoabdominal aneurysm-damage control with superior mesenteric artery snorkel and thoracic stent-graft exclusion. Ann Vasc Surg 2011; 25:555.e5.
  81. Pecoraro F, Pfammatter T, Mayer D, et al. Multiple periscope and chimney grafts to treat ruptured thoracoabdominal and pararenal aortic aneurysms. J Endovasc Ther 2011; 18:642.
  82. Hogendoorn W, Schlösser FJ, Moll FL, et al. Thoracic endovascular aortic repair with the chimney graft technique. J Vasc Surg 2013; 58:502.
  83. De Rango P, Estrera AL, Miller C 3rd, et al. Operative outcomes using a side-branched thoracoabdominal aortic graft (STAG) for thoraco-abdominal aortic repair. Eur J Vasc Endovasc Surg 2011; 41:41.
  84. Conrad MF, Cambria RP. Contemporary management of descending thoracic and thoracoabdominal aortic aneurysms: endovascular versus open. Circulation 2008; 117:841.
  85. Black SA, Wolfe JH, Clark M, et al. Complex thoracoabdominal aortic aneurysms: endovascular exclusion with visceral revascularization. J Vasc Surg 2006; 43:1081.
  86. Böckler D, Kotelis D, Geisbüsch P, et al. Hybrid procedures for thoracoabdominal aortic aneurysms and chronic aortic dissections - a single center experience in 28 patients. J Vasc Surg 2008; 47:724.
  87. Bratzler DW, Dellinger EP, Olsen KM, et al. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Am J Health Syst Pharm 2013; 70:195.
  88. Dake MD, White RA, Diethrich EB, et al. Report on endograft management of traumatic thoracic aortic transections at 30 days and 1 year from a multidisciplinary subcommittee of the Society for Vascular Surgery Outcomes Committee. J Vasc Surg 2011; 53:1091.
  89. Pisimisis GT, Khoynezhad A, Bashir K, et al. Incidence and risk factors of renal dysfunction after thoracic endovascular aortic repair. J Thorac Cardiovasc Surg 2010; 140:S161.
  90. Riesenman PJ, Farber MA, Rich PB, et al. Outcomes of surgical and endovascular treatment of acute traumatic thoracic aortic injury. J Vasc Surg 2007; 46:934.
  91. Piffaretti G, Mariscalco G, Bonardelli S, et al. Predictors and outcomes of acute kidney injury after thoracic aortic endograft repair. J Vasc Surg 2012; 56:1527.
  92. Schlösser FJ, Verhagen HJ, Lin PH, et al. TEVAR following prior abdominal aortic aneurysm surgery: increased risk of neurological deficit. J Vasc Surg 2009; 49:308.
  93. Ullery BW, Quatromoni J, Jackson BM, et al. Impact of intercostal artery occlusion on spinal cord ischemia following thoracic endovascular aortic repair. Vasc Endovascular Surg 2011; 45:519.
  94. Keith CJ Jr, Passman MA, Carignan MJ, et al. Protocol implementation of selective postoperative lumbar spinal drainage after thoracic aortic endograft. J Vasc Surg 2012; 55:1.
  95. Amabile P, Grisoli D, Giorgi R, et al. Incidence and determinants of spinal cord ischaemia in stent-graft repair of the thoracic aorta. Eur J Vasc Endovasc Surg 2008; 35:455.
  96. Buth J, Harris PL, Hobo R, et al. Neurologic complications associated with endovascular repair of thoracic aortic pathology: Incidence and risk factors. a study from the European Collaborators on Stent/Graft Techniques for Aortic Aneurysm Repair (EUROSTAR) registry. J Vasc Surg 2007; 46:1103.
  97. Cheung AT, Pochettino A, McGarvey ML, et al. Strategies to manage paraplegia risk after endovascular stent repair of descending thoracic aortic aneurysms. Ann Thorac Surg 2005; 80:1280.
  98. O'Callaghan A, Mastracci TM, Eagleton MJ. Staged endovascular repair of thoracoabdominal aortic aneurysms limits incidence and severity of spinal cord ischemia. J Vasc Surg 2015; 61:347.
  99. Cheung AT, Weiss SJ, McGarvey ML, et al. Interventions for reversing delayed-onset postoperative paraplegia after thoracic aortic reconstruction. Ann Thorac Surg 2002; 74:413.
  100. Khoynezhad A, Donayre CE, Bui H, et al. Risk factors of neurologic deficit after thoracic aortic endografting. Ann Thorac Surg 2007; 83:S882.
  101. Leurs LJ, Bell R, Degrieck Y, et al. Endovascular treatment of thoracic aortic diseases: combined experience from the EUROSTAR and United Kingdom Thoracic Endograft registries. J Vasc Surg 2004; 40:670.
  102. Jim J, Rubin BG, Moon MR, et al. Arterial access for thoracic endograft placement. Ann Vasc Surg 2010; 24:640.
  103. Skagius E, Bosnjak M, Björck M, et al. Percutaneous closure of large femoral artery access with Prostar XL in thoracic endovascular aortic repair. Eur J Vasc Endovasc Surg 2013; 46:558.
  104. Vandy FC, Girotti M, Williams DM, et al. Iliofemoral complications associated with thoracic endovascular aortic repair: frequency, risk factors, and early and late outcomes. J Thorac Cardiovasc Surg 2014; 147:960.
  105. Bhutia SG, Wales L, Jackson R, et al. Descending thoracic endovascular aneurysm repair: antegrade approach via ascending aortic conduit. Eur J Vasc Endovasc Surg 2011; 41:38.
  106. Pearce BJ, Jordan WD Jr. Using IVUS during EVAR and TEVAR: improving patient outcomes. Semin Vasc Surg 2009; 22:172.
  107. Itoga NK, Kakazu CZ, White RA. Enhanced visual clarity of intimal tear using real-time 3D transesophageal echocardiography during TEVAR of a type B dissection. J Endovasc Ther 2013; 20:221.
  108. Qu L, Raithel D. Techniques for precise thoracic endograft placement. J Vasc Surg 2009; 49:1069.
  109. Rylski B, Blanke P, Siepe M, et al. Results of high-risk endovascular procedures in patients with non-dissected thoracic aortic pathology: intermediate outcomes. Eur J Cardiothorac Surg 2013; 44:156.
  110. Scali ST, Beck AW, Butler K, et al. Pathology-specific secondary aortic interventions after thoracic endovascular aortic repair. J Vasc Surg 2014; 59:599.
  111. Verzini F, Loschi D, De Rango P, et al. Current results of total endovascular repair of thoracoabdominal aortic aneurysms. J Cardiovasc Surg (Torino) 2014; 55:9.
  112. Ehlert BA, Durham CA, Parker FM, et al. Impact of operative indication and surgical complexity on outcomes after thoracic endovascular aortic repair at National Surgical Quality Improvement Program Centers. J Vasc Surg 2011; 54:1629.
  113. Clough RE, Patel AS, Lyons OT, et al. Pathology specific early outcome after thoracic endovascular aortic repair. Eur J Vasc Endovasc Surg 2014; 48:268.
  114. Knowles M, Murphy EH, Dimaio JM, et al. The effects of operative indication and urgency of intervention on patient outcomes after thoracic aortic endografting. J Vasc Surg 2011; 53:926.
  115. Etezadi V, Schiro B, Peña CS, et al. Endovascular treatment of descending thoracic aortic disease: single-center, 15-year experience. J Vasc Interv Radiol 2012; 23:468.
  116. Fossaceca R, Guzzardi G, Cerini P, et al. Endovascular treatment of thoracic aortic aneurysm: a single-center experience. Ann Vasc Surg 2013; 27:1020.
  117. Doss M, Wood JP, Balzer J, et al. Emergency endovascular interventions for acute thoracic aortic rupture: four-year follow-up. J Thorac Cardiovasc Surg 2005; 129:645.
  118. Schaffer JM, Lingala B, Miller DC, et al. Midterm survival after thoracic endovascular aortic repair in more than 10,000 Medicare patients. J Thorac Cardiovasc Surg 2015; 149:808.
  119. Chung J, Corriere MA, Veeraswamy RK, et al. Risk factors for late mortality after endovascular repair of the thoracic aorta. J Vasc Surg 2010; 52:549.
  120. Wang GJ, Fairman RM, Jackson BM, et al. The outcome of thoracic endovascular aortic repair (TEVAR) in patients with renal insufficiency. J Vasc Surg 2009; 49:42.
  121. Guillou M, Bianchini A, Sobocinski J, et al. Endovascular treatment of thoracoabdominal aortic aneurysms. J Vasc Surg 2012; 56:65.
  122. Marrocco-Trischitta MM, Melissano G, Kahlberg A, et al. Chronic kidney disease classification stratifies mortality risk after elective stent graft repair of the thoracic aorta. J Vasc Surg 2009; 49:296.
  123. Arnaoutakis GJ, Schneider EB, Arnaoutakis DJ, et al. Influence of gender on outcomes after thoracic endovascular aneurysm repair. J Vasc Surg 2014; 59:45.
  124. Jackson BM, Woo EY, Bavaria JE, Fairman RM. Gender analysis of the pivotal results of the Medtronic Talent Thoracic Stent Graft System (VALOR) trial. J Vasc Surg 2011; 54:358.
  125. Czerny M, Hoebartner M, Sodeck G, et al. The influence of gender on mortality in patients after thoracic endovascular aortic repair. Eur J Cardiothorac Surg 2011; 40:e1.
  126. Williams JB, Andersen ND, Bhattacharya SD, et al. Retrograde ascending aortic dissection as an early complication of thoracic endovascular aortic repair. J Vasc Surg 2012; 55:1255.
  127. Eggebrecht H, Thompson M, Rousseau H, et al. Retrograde ascending aortic dissection during or after thoracic aortic stent graft placement: insight from the European registry on endovascular aortic repair complications. Circulation 2009; 120:S276.
  128. Tshomba Y, Bertoglio L, Marone EM, et al. Retrograde type A dissection after endovascular repair of a "zone 0" nondissecting aortic arch aneurysm. Ann Vasc Surg 2010; 24:952.e1.
  129. Czerny M, Reser D, Eggebrecht H, et al. Aorto-bronchial and aorto-pulmonary fistulation after thoracic endovascular aortic repair: an analysis from the European Registry of Endovascular Aortic Repair Complications. Eur J Cardiothorac Surg 2015; 48:252.
  130. Drinkwater SL, Goebells A, Haydar A, et al. The incidence of spinal cord ischaemia following thoracic and thoracoabdominal aortic endovascular intervention. Eur J Vasc Endovasc Surg 2010; 40:729.
  131. Zoli S, Roder F, Etz CD, et al. Predicting the risk of paraplegia after thoracic and thoracoabdominal aneurysm repair. Ann Thorac Surg 2010; 90:1237.
  132. Martin DJ, Martin TD, Hess PJ, et al. Spinal cord ischemia after TEVAR in patients with abdominal aortic aneurysms. J Vasc Surg 2009; 49:302.
  133. Wong CS, Healy D, Canning C, et al. A systematic review of spinal cord injury and cerebrospinal fluid drainage after thoracic aortic endografting. J Vasc Surg 2012; 56:1438.
  134. Eagleton MJ, Shah S, Petkosevek D, et al. Hypogastric and subclavian artery patency affects onset and recovery of spinal cord ischemia associated with aortic endografting. J Vasc Surg 2014; 59:89.
  135. Ullery BW, Cheung AT, Fairman RM, et al. Risk factors, outcomes, and clinical manifestations of spinal cord ischemia following thoracic endovascular aortic repair. J Vasc Surg 2011; 54:677.
  136. Scali ST, Wang SK, Feezor RJ, et al. Preoperative prediction of spinal cord ischemia after thoracic endovascular aortic repair. J Vasc Surg 2014; 60:1481.
  137. Svensson LG, Kouchoukos NT, Miller DC, et al. Expert consensus document on the treatment of descending thoracic aortic disease using endovascular stent-grafts. Ann Thorac Surg 2008; 85:S1.
  138. Bobadilla JL, Wynn M, Tefera G, Acher CW. Low incidence of paraplegia after thoracic endovascular aneurysm repair with proactive spinal cord protective protocols. J Vasc Surg 2013; 57:1537.
  139. Czerny M, Eggebrecht H, Sodeck G, et al. Mechanisms of symptomatic spinal cord ischemia after TEVAR: insights from the European Registry of Endovascular Aortic Repair Complications (EuREC). J Endovasc Ther 2012; 19:37.
  140. Gutsche JT, Cheung AT, McGarvey ML, et al. Risk factors for perioperative stroke after thoracic endovascular aortic repair. Ann Thorac Surg 2007; 84:1195.
  141. Patel R, Muthu C, Goh KH. Subclavian stump syndrome causing a posterior circulation stroke after thoracic endovascular aneurysm repair (TEVAR) with adjunctive carotid to subclavian bypass and endovascular embolization of the left subclavian artery. Ann Vasc Surg 2014; 28:1318.e13.
  142. Zahn R, Erbel R, Nienaber CA, et al. Endovascular aortic repair of thoracic aortic disease: early and 1-year results from a German multicenter registry. J Endovasc Ther 2013; 20:265.
  143. Preventza O, Hughes K. Endovascular repair of the descending thoracic aorta: a tale of two nations. J Endovasc Ther 2013; 20:273.
  144. Demers P, Miller DC, Mitchell RS, et al. Midterm results of endovascular repair of descending thoracic aortic aneurysms with first-generation stent grafts. J Thorac Cardiovasc Surg 2004; 127:664.
  145. Svensson LG. Device discordancy: lost cords, quick-fix seekers, quality, and ethics. J Thorac Cardiovasc Surg 2006; 131:261.
  146. Dake MD, Miller DC, Mitchell RS, et al. The "first generation" of endovascular stent-grafts for patients with aneurysms of the descending thoracic aorta. J Thorac Cardiovasc Surg 1998; 116:689.
  147. Patterson BO, Holt PJ, Nienaber C, et al. Management of the left subclavian artery and neurologic complications after thoracic endovascular aortic repair. J Vasc Surg 2014; 60:1491.
  148. Riesenman PJ, Farber MA, Mendes RR, et al. Coverage of the left subclavian artery during thoracic endovascular aortic repair. J Vasc Surg 2007; 45:90.
  149. Si Y, Fu W, Liu Z, et al. Coverage of the left subclavian artery without revascularization during thoracic endovascular repair is feasible: a prospective study. Ann Vasc Surg 2014; 28:850.
  150. Maldonado TS, Dexter D, Rockman CB, et al. Left subclavian artery coverage during thoracic endovascular aortic aneurysm repair does not mandate revascularization. J Vasc Surg 2013; 57:116.
  151. Klocker J, Koell A, Erlmeier M, et al. Ischemia and functional status of the left arm and quality of life after left subclavian artery coverage during stent grafting of thoracic aortic diseases. J Vasc Surg 2014; 60:64.
  152. Falkenberg M, Lönn L, Schroeder T, Delle M. TEVAR and covering the celiac artery. Is it safe or not? J Cardiovasc Surg (Torino) 2010; 51:177.
  153. Gabriel EA, Locali RF, Romano CC, et al. Analysis of the inflammatory response in endovascular treatment of aortic aneurysms. Eur J Cardiothorac Surg 2007; 31:406.
  154. Ishida M, Kato N, Hirano T, et al. Thoracic CT findings following endovascular stent-graft treatment for thoracic aortic aneurysm. J Endovasc Ther 2007; 14:333.
  155. Eggebrecht H, Mehta RH, Metozounve H, et al. Clinical implications of systemic inflammatory response syndrome following thoracic aortic stent-graft placement. J Endovasc Ther 2008; 15:135.
  156. Sakai T, Dake MD, Semba CP, et al. Descending thoracic aortic aneurysm: thoracic CT findings after endovascular stent-graft placement. Radiology 1999; 212:169.
  157. Schoder M, Cartes-Zumelzu F, Grabenwöger M, et al. Elective endovascular stent-graft repair of atherosclerotic thoracic aortic aneurysms: clinical results and midterm follow-up. AJR Am J Roentgenol 2003; 180:709.
  158. Preventza O, Wheatley GH 3rd, Ramaiah VG, et al. Management of endoleaks associated with endovascular treatment of descending thoracic aortic diseases. J Vasc Surg 2008; 48:69.
  159. Bischoff MS, Geisbüsch P, Kotelis D, et al. Clinical significance of type II endoleaks after thoracic endovascular aortic repair. J Vasc Surg 2013; 58:643.
  160. Ganapathi AM, Andersen ND, Hanna JM, et al. Comparison of attachment site endoleak rates in Dacron versus native aorta landing zones after thoracic endovascular aortic repair. J Vasc Surg 2014; 59:921.
  161. Tadros RO, Lipsitz EC, Chaer RA, et al. A multicenter experience of the management of collapsed thoracic endografts. J Vasc Surg 2011; 53:1217.
  162. Shukla AJ, Jeyabalan G, Cho JS. Late collapse of a thoracic endoprosthesis. J Vasc Surg 2011; 53:798.
  163. Perek B, Juszkat R, Kulesza J, Jemielity M. Stent grafts separation 6 years after endovascular repair of a thoracic aortic aneurysm. J Vasc Interv Radiol 2014; 25:1650.
  164. Szeto WY, Desai ND, Moeller P, et al. Reintervention for endograft failures after thoracic endovascular aortic repair. J Thorac Cardiovasc Surg 2013; 145:S165.