J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text HTML] [Full Text PDF] （in Japanese / 641KB） [Members Only]

J.Jpn. Surg. Soc.. 110(5): 266-270, 2009

Feature topic

CURRENT STATUS AND FUTURE OF TEVAR FOR DESCENDING THORACIC AORTIC ANEURYSM

1) Department of Radiology, Nara Medical University
2) Department of Thoracic and Cardiovascular Surgery, Nara Medical University
3) Department of Radiology, Nara Prefectural Mimuro Hospital

Kimihiko Kichikawa1), Shoji Sakaguchi1), Hirofumi Itoh1), Shigeo Ichihashi1), Nobuoki Tabayashi2), Shigeki Taniguchi2), Wataru Higashiura3)

As a new option for treatment of thoracic aortic aneurysm, thoracic endovascular aneurysm repair (TEVAR) has become more popular recently in Japan, because TEVAR is less invasive and TAG and Tallent are approved as a commercially available device for descending thoracic aorta. The results of TEVAR showed more favorable compared to open surgery. Incidence of paraplegia after TEVAR is lower than that of open surgery. However we performed spinal cord drainage to avoid paraplegia in patients with history of the aortic aneurysm repair or long segmental coverage with stent graft. It has higher risk of injury to the iliac artery compared to EVAR, and in patients with small iliac artery and/or severe calcified artery, iliac conduit should be made before TEVAR. To expand the indication of TEAVR and to obtain better outcome, team approach with borderless and improvement of devices should be required. TEAVR will become more predominant and safer treatment in the future.

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