Update on thoracic endovascular aneurysm repair : New stent graft designs

Abstract

In the last decade, new stent graft designs have evolved to tackle challenges in thoracic endovascular aortic repair. Aspecific focus on access vessel issues has led to the introduction of new low-profile endograft designs for most of the major products. The main objective of this article is to provide an overview of the available publications on new stent graft designs. Assessing recent publications on the major reiterations of thoracic endografts, benefits and drawbacks are discussed. Recent reiterations of major endografts for thoracic aortic endovascular repair have focused mainly on the development of low-profile devices. Through alterations on graft fabric as well as stent material and design, delivery systems were reduced in profile, thus, reducing access vessel complications or enabling an endovascular procedure altogether. Long-term data are already available for one endoprosthesis. Other refinements include insitu adaptation of the stent graft to the aortic arch curvature as well as the option of staged deployment to allow more precision and reduce manipulation close to supra-aortic branches. Especially in the case of low-profile endografts, preliminary and long-term results of access vessel complications are promising. In order to draw final conclusions as to how durable the results of aneurysm exclusion are, more long-term studies are warranted.