Management of Descending Thoracic Aortic Diseases: Similarities and Differences Among Cardiovascular Guidelines
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Management of Descending Thoracic Aortic Diseases: Similarities and Differences Among Cardiovascular Guidelines. / Spanos, Konstantinos; Nana, Petroula; Behrendt, Christian-Alexander; Kouvelos, George; Panuccio, Giuseppe; Heidemann, Franziska; Matsagkas, Miltiadis; Debus, E Sebastian; Giannoukas, Athanasios; Kölbel, Tilo.
in: J ENDOVASC THER, Jahrgang 28, Nr. 2, 04.2021, S. 323-331.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Management of Descending Thoracic Aortic Diseases: Similarities and Differences Among Cardiovascular Guidelines
AU - Spanos, Konstantinos
AU - Nana, Petroula
AU - Behrendt, Christian-Alexander
AU - Kouvelos, George
AU - Panuccio, Giuseppe
AU - Heidemann, Franziska
AU - Matsagkas, Miltiadis
AU - Debus, E Sebastian
AU - Giannoukas, Athanasios
AU - Kölbel, Tilo
PY - 2021/4
Y1 - 2021/4
N2 - Cardiovascular societies have developed recommendations regarding the management of thoracic aortic diseases. While improvements in treatment have been observed during the past decade in regard to patient selection, thoracic endovascular aortic repair (TEVAR) and associated techniques, and high-volume centralization, the broad expansion of TEVAR has raised considerations about its indications, appropriateness, limitations, and application. The aim of this systematic review was to assess the similarities and differences among current cardiovascular societies' guidelines for the management of thoracic aortic diseases. The MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials were searched from January 2009 to May 2020. The initial search identified 990 articles. After exclusion of duplicate or inappropriate articles, the final analysis included 5 articles from cardiovascular societies published between 2010 and 2020. Selected controversial topics were analyzed, including diagnosis, imaging, spinal cord ischemia prevention, and management of the most important thoracic aortic pathologies. The analysis included data concerning the therapeutic approach in acute and chronic type B aortic dissection, penetrating aortic ulcer, intramural hematoma, thoracic aortic aneurysm, and traumatic aortic injury, as well a discussion of inflammatory aneurysms, aortitis, and genetic syndromes. The review presents consistent and controversial recommendations, as well as "gray zone" issues that need further investigation. There was significant overlap and agreement among the 5 societies regarding the management of thoracic aortic diseases. Especially in dissection and aneurysm management, TEVAR has established its role as the treatment of choice. However, robust evidence is still needed in many aspects of the management of thoracic aortic pathologies.
AB - Cardiovascular societies have developed recommendations regarding the management of thoracic aortic diseases. While improvements in treatment have been observed during the past decade in regard to patient selection, thoracic endovascular aortic repair (TEVAR) and associated techniques, and high-volume centralization, the broad expansion of TEVAR has raised considerations about its indications, appropriateness, limitations, and application. The aim of this systematic review was to assess the similarities and differences among current cardiovascular societies' guidelines for the management of thoracic aortic diseases. The MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials were searched from January 2009 to May 2020. The initial search identified 990 articles. After exclusion of duplicate or inappropriate articles, the final analysis included 5 articles from cardiovascular societies published between 2010 and 2020. Selected controversial topics were analyzed, including diagnosis, imaging, spinal cord ischemia prevention, and management of the most important thoracic aortic pathologies. The analysis included data concerning the therapeutic approach in acute and chronic type B aortic dissection, penetrating aortic ulcer, intramural hematoma, thoracic aortic aneurysm, and traumatic aortic injury, as well a discussion of inflammatory aneurysms, aortitis, and genetic syndromes. The review presents consistent and controversial recommendations, as well as "gray zone" issues that need further investigation. There was significant overlap and agreement among the 5 societies regarding the management of thoracic aortic diseases. Especially in dissection and aneurysm management, TEVAR has established its role as the treatment of choice. However, robust evidence is still needed in many aspects of the management of thoracic aortic pathologies.
KW - Aneurysm, Dissecting/diagnostic imaging
KW - Aorta, Thoracic/diagnostic imaging
KW - Aortic Aneurysm, Thoracic/diagnostic imaging
KW - Aortic Diseases/diagnostic imaging
KW - Blood Vessel Prosthesis Implantation/adverse effects
KW - Endovascular Procedures/adverse effects
KW - Humans
KW - Retrospective Studies
KW - Treatment Outcome
U2 - 10.1177/1526602820987808
DO - 10.1177/1526602820987808
M3 - SCORING: Journal article
C2 - 33435805
VL - 28
SP - 323
EP - 331
JO - J ENDOVASC THER
JF - J ENDOVASC THER
SN - 1526-6028
IS - 2
ER -