Vascular Access Challenges in Thoracic Endovascular Aortic Repair: A Literature Review
This review aims to comprehensively summarize access challenges in thoracic endovascular aortic repair (TEVAR) by describing vascular access routes, associated risks, outcomes, and complications. A literature search was conducted utilizing the PubMed (Medline), Scopus, and Web of Science databases....
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| Published in: | Annals of vascular surgery Vol. 94; pp. 22 - 31 |
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| Main Authors: | , , , , , , |
| Format: | Journal Article |
| Language: | English |
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Netherlands
Elsevier Inc
01-08-2023
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| Abstract | This review aims to comprehensively summarize access challenges in thoracic endovascular aortic repair (TEVAR) by describing vascular access routes, associated risks, outcomes, and complications.
A literature search was conducted utilizing the PubMed (Medline), Scopus, and Web of Science databases. Qualitative and quantitative data from selected studies are extracted and discussed according to available standards for narrative reviews.
In total, there were 109 eligible studies based on predefined inclusion- and exclusion criteria. There were 39 original articles or reviews and 57 case series or case reports. This article summarizes the evidence from these studies and discusses traditional retrograde access routes and techniques for TEVAR via a femoral or iliac route, with or without the use of conduits. Next, alternative antegrade access routes and techniques via a brachial, axillary, carotid, ascending aorta, transapical, transcaval, or another route are discussed. Vascular access complications are presented with specific attention to the importance of gender and alternative antegrade access routes.
Multiple access routes and techniques are currently available to overcome access challenges associated with TEVAR, based on low grade evidence from heterogeneous studies. Future research that compares different access routes and techniques might help in the development of a tailored access protocol for specific patients with challenging TEVAR access. |
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| AbstractList | BACKGROUNDThis review aims to comprehensively summarize access challenges in thoracic endovascular aortic repair (TEVAR) by describing vascular access routes, associated risks, outcomes, and complications. METHODSA literature search was conducted utilizing the PubMed (Medline), Scopus, and Web of Science databases. Qualitative and quantitative data from selected studies are extracted and discussed according to available standards for narrative reviews. RESULTSIn total, there were 109 eligible studies based on predefined inclusion- and exclusion criteria. There were 39 original articles or reviews and 57 case series or case reports. This article summarizes the evidence from these studies and discusses traditional retrograde access routes and techniques for TEVAR via a femoral or iliac route, with or without the use of conduits. Next, alternative antegrade access routes and techniques via a brachial, axillary, carotid, ascending aorta, transapical, transcaval, or another route are discussed. Vascular access complications are presented with specific attention to the importance of gender and alternative antegrade access routes. CONCLUSIONSMultiple access routes and techniques are currently available to overcome access challenges associated with TEVAR, based on low grade evidence from heterogeneous studies. Future research that compares different access routes and techniques might help in the development of a tailored access protocol for specific patients with challenging TEVAR access. This review aims to comprehensively summarize access challenges in thoracic endovascular aortic repair (TEVAR) by describing vascular access routes, associated risks, outcomes, and complications. A literature search was conducted utilizing the PubMed (Medline), Scopus, and Web of Science databases. Qualitative and quantitative data from selected studies are extracted and discussed according to available standards for narrative reviews. In total, there were 109 eligible studies based on predefined inclusion- and exclusion criteria. There were 39 original articles or reviews and 57 case series or case reports. This article summarizes the evidence from these studies and discusses traditional retrograde access routes and techniques for TEVAR via a femoral or iliac route, with or without the use of conduits. Next, alternative antegrade access routes and techniques via a brachial, axillary, carotid, ascending aorta, transapical, transcaval, or another route are discussed. Vascular access complications are presented with specific attention to the importance of gender and alternative antegrade access routes. Multiple access routes and techniques are currently available to overcome access challenges associated with TEVAR, based on low grade evidence from heterogeneous studies. Future research that compares different access routes and techniques might help in the development of a tailored access protocol for specific patients with challenging TEVAR access. |
| Author | Pirrelli, Stefano Lomazzi, Chiara van Herwaarden, Joost A. Domanin, Maurizio Trimarchi, Santi Piffaretti, Gabriele Mandigers, Tim J. |
| Author_xml | – sequence: 1 givenname: Tim J. orcidid: 0000-0002-9508-4088 surname: Mandigers fullname: Mandigers, Tim J. email: mandigers.tim@gmail.com organization: Department of Vascular Surgery, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy – sequence: 2 givenname: Chiara surname: Lomazzi fullname: Lomazzi, Chiara organization: Department of Vascular Surgery, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy – sequence: 3 givenname: Maurizio surname: Domanin fullname: Domanin, Maurizio organization: Department of Vascular Surgery, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy – sequence: 4 givenname: Stefano surname: Pirrelli fullname: Pirrelli, Stefano organization: Vascular Surgery Unit, ASST Papa Giovanni XXIII, Ospedali di Bergamo, Bergamo, Italy – sequence: 5 givenname: Gabriele surname: Piffaretti fullname: Piffaretti, Gabriele organization: Vascular Surgery, Department of Medicine and Surgery, University of Insubria, Varese, Italy – sequence: 6 givenname: Joost A. surname: van Herwaarden fullname: van Herwaarden, Joost A. organization: Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, the Netherlands – sequence: 7 givenname: Santi surname: Trimarchi fullname: Trimarchi, Santi organization: Department of Vascular Surgery, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy |
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| Title | Vascular Access Challenges in Thoracic Endovascular Aortic Repair: A Literature Review |
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