test 6 endovascular repair

Question 1

ENDOVASCULAR REPAIR history

Answer 1

 1
st done in 1991 on abdominal aortic aneurysm
 Now we can do it on thoracic aneurysms due to increased technology which allows precise placement in a high pressure system
 Before only open repairs

Question 2

Thoracic EndoVascular Aortic Repair (TEVAR)

Answer 2

 Requires femoral access
 Flouroscopy
 Graft self-deploys
 Req’s flouroscopy to check position
 Requires systemic heparinization

Question 3

ENDOVASCULAR REPAIR (TEVAR)

Answer 3

 Requires proximal “Landing Zone” (good spot of healthy tissue) of 15mm length
 Distal end needs to be non-aneurysmal
 Con: Side branches – possibility of occluding a vessel that branches off the aorta
 Considerations: Aortic Tortuosity, calcification, atherosclerosis

Question 4

TEVAR Advantages

Answer 4

 Reduces mortality
 Reduces morbidity
 Less blood loss
 Quicker recovery
 Hemodynamic stability
 Pulmonary and cardiac comorbidities that may have not made them a candidate for open surgeries, allow them to have this option.

Question 5

TEVAR Complications

Answer 5

 Conversion to open procedure
 Aortic Rupture / dissection
 Malposition – causing visceral ischemia
 Bleeding
 Endoleak
 Blood flows back into the aneurysmal sac after the endovascular graft is placed
 Usually observe and hope it spontaneously resolves
 Stroke
 Paraplegia
 Contrast Nephropathy