Treatment of Thoracic and Thoraco-abdominal Aortic Pathology in the Endovascular Era

The Relationship Between Shaggy Aorta and Embolic Complications After Thoracic Endovascular Aneurysm Repair: Can We Smooth the Rough Covering?

“…Although no randomised controlled trials (RCTs) exist that compare open surgery (OS) with thoracic endovascular aneurysm repair (TEVAR), the much less invasive nature of TEVAR when compared with OS has resulted in broad adoption of endovascular surgery for these pathologies, owing much to both patients' and surgeons' preferences. 1 Although systematic reviews and meta-analyses of retrospective series showed a significant reduction in peri-operative morbidity and mortality, the risk of stroke was not affected by TEVAR. 2 Embolism from manipulation of devices within the aorta is generally thought to be the main cause of stroke following TEVAR, emphasising the importance of care during the intraoperative period and the need for careful pre-operative planning.…”