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CC BY-NC-ND 4.0 · Aorta (Stamford) 2024; 12(01): 013-019
DOI: 10.1055/s-0044-1791670
Review Article

Endovascular Repair of Zone 0 Ascending Aortic Aneurysm: A Review of Current Knowledge and Developing Technology

Sarah Halbert
1   Division of Cardiothoracic Surgery, Heart Center, Veterans Affairs Medical Center, Washington, District of Columbia
2   Department of Surgery, MedStar Georgetown University Hospital, Washington, District of Columbia
,
John Kucera
3   Department of Surgery, Walter Reed National Military Medical Center Medical Center, Bethesda, Maryland
,
Jared Antevil
1   Division of Cardiothoracic Surgery, Heart Center, Veterans Affairs Medical Center, Washington, District of Columbia
4   Department of Surgery, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
,
Christian Nagy
1   Division of Cardiothoracic Surgery, Heart Center, Veterans Affairs Medical Center, Washington, District of Columbia
4   Department of Surgery, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
,
Shawn Sarin
4   Department of Surgery, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
,
Gregory Trachiotis 
1   Division of Cardiothoracic Surgery, Heart Center, Veterans Affairs Medical Center, Washington, District of Columbia
4   Department of Surgery, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
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Abstract

Aortic aneurysms represent the 15th leading cause of death in men and women over 55 years of age. Where historically these lesions were all addressed via an open approach, endovascular aortic repair has entirely altered the way that surgeons approach aortic lesions. Although it was initially employed for patients who were poor surgical candidates, endovascular repair is now standard for abdominal aortic aneurysms and aneurysms in the descending thoracic aorta. Open surgery remains the gold standard for management of ascending aneurysms, in part due to the limitations portended by the anatomy of the ascending aorta, although increasing evidence suggests that endovascular approaches are feasible and may sometimes be optimal for patient outcomes. Here, we present some of the anatomical and technical challenges of the endovascular approach to these “Zone 0” aneurysms, the associated complications, and the current state of device development.

Keywords

ascending aorta - thoracic endovascular aortic repair - stent grafting - landing zone


Publication History

Received: 03 August 2023

Accepted: 05 September 2024

Article published online:
15 November 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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