ABSTRACT
The development of thoracic endovascular aortic repair (TEVAR) has dramatically revolutionized the eld of cardiovascular surgery. Since Parodi’s rst description of an intraluminal stent graft device for the treatment of abdominal aortic aneurysms (AAA),1 endovascular device technology has rapidly evolved to treat the multiple pathologies seen in the thoracic aorta. In 1994, Dake rst reported the initial Stanford experience with 13 patients undergoing endovascular therapy of descending thoracic aortic aneurysms.2 Since then, indications involving off-label use have expanded to include the treatment of aortic dissections, traumatic transections, penetrating atherosclerotic ulcers (PAUs), and intramural haematoma (IMH). Currently, there are four Food and Drug Administration (FDA)-approved stent graft devices approved for the treatment of descending thoracic aortic aneurysms. Questions and concerns remain regarding the appropriate timing, indication for intervention, and durability of this fast evolving technology. TEVAR has gained worldwide acceptance in the treatment of pathologies of the descending thoracic aorta (DTA).
