Key result
Review outlines techniques to reduce aortic impulse for precise TEVAR deployment without reporting quantitative results.
Why the study?
Exact stent-graft deployment is key to successful TEVAR, but the best technique to lower blood pressure and reduce aortic impulse to achieve this was unclear.
Do techniques to reduce aortic impulse improve precise stent-graft placement in patients undergoing TEVAR?
Do techniques to reduce aortic impulse improve precise stent-graft placement in patients undergoing TEVAR?
This review assesses various techniques to reduce aortic impulse for precise stent-graft deployment during TEVAR.
Aortic impulse reduction techniques for precise TEVAR deployment lack supporting evidence; prospective trials needed before clinical adoption.
Thoracic endovascular aortic repair (TEVAR) for aortic pathologies requires sufficient landing zone of ideally more than 25 mm for safe anchoring of the stent-graft and prevention of endoleaks. In the aortic arch and at the thoracoabdominal transition, landing zone length is usually limited by the offspring of the major aortic side-branches. Exact deployment of the stent-graft to effectively use the whole length of the landing zone and to prevent occlusion of one of the side-branches is key to successful TEVAR. There are numerous techniques described to lower blood pressure and to reduce or eliminate aortic impulse to facilitate exact deployment of stent-grafts including pharmacologic blood pressure lowering, adenosine-induced asystole, inflow occlusion, and rapid pacing. Aim of this review was to assess the current literature to identify which of the techniques is best suited to prevent displacement and allow for precise placement of the stent-graft and safe balloon-molding.
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Gottardi et al. (2020) conducted a review in Aortic pathologies requiring TEVAR. Techniques to reduce aortic impulse (pharmacologic blood pressure lowering, adenosine-induced asystole, inflow occlusion, rapid pacing) was evaluated on Prevention of displacement and precise placement of the stent-graft and safe balloon-molding. This review aimed to assess techniques to reduce aortic impulse for precise stent-graft deployment during TEVAR, but no quantitative results were reported in the abstract.
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