Comment on: Indications for Thoracic Endovascular Aortic Repair (TEVAR): A Brief Review by Frank Manetta, MD, Joshua Newman, MS, Allan Mattia, MD. Int J Angiol 2018; 28:177–184

Indications for Thoracic EndoVascular Aortic Repair (TEVAR): A Brief Review

I appreciated the broad review by Dr. Manetta and colleagues of developments and devices for thoracic endovascular repair (TEVAR).[1] The authors did not include the Relay stent-graft (Terumo Aortic, formerly Bolton Medical, Sunrise, FL). This device was developed to treat thoracic aortic pathologies, specifically thoracic aortic aneurysms (TAA), pseudoaneurysms, penetrating atherosclerotic ulcers (PAU), dissection, transection, and intramural hematoma (IMH) in adult patients and has been reviewed in the literature.[2] Relay is currently approved in the US for the treatment of TAAs and PAUs. Published results show low rates of stroke, endoleak, and reintervention.[3] [4] [5] The device is available in bare stent and nonbare stent (NBS) configurations. A low-profile configuration (19–23 Fr, RelayPro) received the Conformité Européene (CE) mark in 2018. Furthermore, scalloped and branched configurations of Relay allow for treatment of aortic arch lesions.[6] [7] [8]

• References

• 1 Manetta F, Newman J, Mattia A. Indications for thoracic endovascular aortic repair (TEVAR): a brief review. Int J Angiol 2018; 27 (04) 177-184
• 2 Khayat M, Cooper KJ, Khaja MS, Gandhi R, Bryce YC, Williams DM. Endovascular management of acute aortic dissection. Cardiovasc Diagn Ther 2018; 8 (Suppl. 01) S97-S107
• 3 Farber MA, Lee WA, Szeto WY, Panneton JM, Kwolek CJ. Initial and midterm results of the Bolton Relay thoracic aortic endovascular pivotal trial. J Vasc Surg 2017; 65 (06) 1556-1566.e1
• 4 Riambau V, Zipfel B, Coppi G. , et al; RELAY Endovascular Registry for Thoracic Disease RESTORE Investigators. Final operative and midterm results of the European experience in the RELAY Endovascular Registry for Thoracic Disease (RESTORE) study. J Vasc Surg 2011; 53 (03) 565-573
• 5 Zipfel B, Zaefferer P, Riambau V. , et al; RESTORE II Study Group. Worldwide results from the RESTORE II on elective endografting of thoracic aneurysms and dissections. J Vasc Surg 2016; 63 (06) 1466-1475
• 6 Czerny M, Schmidli J, Adler S. , et al. Current options and recommendations for the treatment of thoracic aortic pathologies involving the aortic arch: an expert consensus document of the European Association for Cardio-Thoracic Surgery (EACTS) & the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg 2018 ; (e-pub ahead of print). Doi: 10.1016/j.ejvs.2018.09.016
• 7 Makaloski V, Tsilimparis N, Rohlffs F, Heidemann F, Debus ES, Kölbel T. Endovascular total arch replacement techniques and early results. Ann Cardiothorac Surg 2018; 7 (03) 380-388
• 8 Rudarakanchana N, Jenkins MP. Hybrid and total endovascular repair of the aortic arch. Br J Surg 2018; 105 (04) 315-327