European Societies Issue Position Statement on TEVAR

May 4, 2012—A position statement on thoracic endovascular aortic repair (TEVAR) for the treatment of aortic diseases has been issued by the European Association for Cardio-Thoracic Surgery and the European Society of Cardiology in collaboration with the European Association of Percutaneous Cardiovascular Interventions. The statement was drafted by Martin Grabenwöger, MD, et al and was published online ahead of print in the European Heart Journal.

According to the statement, the practice of TEVAR has prompted a requirement to systematically consider the indications, appropriateness, limitations, and delivery of this treatment, which has been adopted by many specialists, including cardiologists, cardiovascular surgeons, radiologists, and vascular surgeons. The authors stated that their task was to generate a multidisciplinary position statement that supports and advises all clinicians utilizing this therapeutic technology.

The statement focuses on the main diagnoses—thoracic aortic aneurysm, thoracic aortic dissection of the descending aorta (type B according to the Stanford classification), and thoracic aortic injury—as well as the indications and applicability of TEVAR and information regarding its limitations and complications.

In the synopsis section of the position statement, the authors comment “TEVAR has changed aortic medicine, enhancing the armamentarium of the aortic specialist in treating acute and chronic thoracic aortic disease.” They further state, “TEVAR offers a valid treatment option for the elderly patients deemed at excessive risk for open surgery, but also for fit patients with suitable anatomies. Particularly, in patients with traumatic aortic injury and acute complicated thoracic aortic dissection, TEVAR is considered the treatment of choice. A prerequisite is a multidisciplinary team approach in centers with a dedicated interest in aortic diseases. Therefore, the foundation of specialized aortic centers providing the full range of diagnostic and treatment options is strongly recommended.”