Cardiovascular and Interventional Radiological Society of Europe

TEVAR (CME) – online course

55 | 25(for CIRSE members)

Description

Authors: A. Chavan and P. Gkoutzios

Reviewers: R. Uberoi, G. Mauri, S. Müller-Hülsbeck, D. Filipiadis and C. Nice

This course corresponds to chapter 2.2.1.1.3 Aortic Dissection and Aneurysmal Disease in the European Curriculum and Syllabus for IR.

 

Abstract

Open surgical repairs of thoracic aortic lesions may be complex procedures with high morbidity and mortality rates. In comparison, Thoracic Endovascular Aortic Repair (TEVAR) is a less invasive technique to repair thoracic aorta aneurysms, dissections, intramural haematomas (IMH), penetrating atherosclerotic ulcers (PAU) and traumatic aortic lesions. With the TEVAR technique, an endovascular stent graft is inserted in the thoracic aorta, most commonly through a common femoral arterial access, to exclude aneurysms, PAUs or injured aortic segments from the circulation; in aortic dissections (AD) and IMHs, the endografts serve to close the intimal entry tears and appose the separated intima to the adventitia.

Meticulous planning with good quality computerised tomography angiograms (CTA), is essential for the success of treatment. Correct endograft sizing, adequate assessment of the access vessels and adequate availability of suitable endografts, catheters and guide wires are integral parts of proper pre-procedural planning.

This course is aimed at enabling the participant to acquire basic skills in carrying out TEVAR independently.

More complex TEVAR procedures involving the aortic arch, the thoraco-abdominal segment using branched and/or fenestrated stent grafts and detailed management of the ruptured descending thoracic aorta (DTA) shall not be addressed in this basic course.

 

Learning Objectives

  • List various thoracic aortic pathologies treatable by TEVAR.
  • Determine the most suitable treatment strategy with respect to the underlying pathology.
  • Interpret imaging (especially CTA) findings and judge the treatment options with respect to access and target vessels.
  • Select appropriate endograft dimensions.
  • Perform procedural steps in the proper order.
  • Identify the difficulties that may arise during the procedure and be prepared to handle them.
  • Manage acute, early or late complications of TEVAR either by re-intervention or with the assistance of ancillary surgical procedures.

 

Further Information

This course covers a basic level of IR knowledge and is designed for trainees, students or young consultants aiming to acquire essential knowledge or prepare for the EBIR exam. Thereby, it is tailored to the European Curriculum and Syllabus for IR and corresponds to chapter 2.2.1.1.3 Aortic Dissection and Aneurysmal Disease.

The format of the course is interactive and easy to use, including texts, graphics, videos and a quiz to support your learning. The course duration is around one hour and is accredited by the European Accreditation Council for Continuing Medical Education (EACCME) to award 1 European CME credit (ECMEC). The CME accreditation for this course will expire on November 25, 2021. A non-CME accredited version of the course will remain available until the new CME accredited course is published.

Upon purchase, access to complete and revisit the course is granted for an enrolment period of 90 days.

The CME certificate will be available in the myCIRSE area past the enrolment period if the course is completed before November 25, 2021.

Release date: November 2019