TEVAR (2025 – CME) – online course

Description

Authors: A. Chavan and P. Gkoutzios

Reviewers: T. Cleveland, S. Duvnjak, H. Kobeiter, T. Kratimenos, R. Lakshminarayan, C.V. Rjiswijk, R. Uberoi and F. Wolf

This course corresponds to chapter 2.2.1.1.3 Acute aortic syndromes and aneurysmal disease in the European Curriculum and Syllabus for Interventional Radiology.

Abstract

Open surgical repairs of thoracic aortic lesions can be complex procedures with high morbidity and mortality rates [1], [2], [3], [4], [5]. In comparison, for patients with favorable aortic anatomy, thoracic endovascular aortic repair (TEVAR) offers a less invasive alternative for treating thoracic aorta aneurysms, traumatic thoracic aortic lesions, and pathologies responsible for the acute aortic syndrome, including aortic dissections, intramural haematomas (IMH), and penetrating atherosclerotic ulcers (PAU). With the TEVAR technique, an endovascular stent graft is implanted in the thoracic aorta, typically via common femoral arterial access, to exclude aneurysms, PAUs, or injured aortic segments from the circulation. In cases of aortic dissections (AD) and IMHs, endografts function to close the intimal entry tears and appose the separated intima to the adventitia [6], [7].

Meticulous preoperative planning, supported by high-quality computerized tomography angiography (CTA), is essential for 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 designed to equip participants with the basic skills required to perform TEVAR procedures independently. More complex TEVAR procedures involving the aortic arch and the thoraco-abdominal segment, such as those using branched and/or fenestrated stent grafts as well as the detailed management of ruptured descending thoracic aorta (DTA) cases, will 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 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 Interventional Radiology and corresponds to chapter 2.2.1.1.3 Acute aortic syndromes 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 two and a half hours 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 March 31, 2027. A non-CME accredited version of the course will remain available until April 01, 2029.

The acquired CME Certificate will be available in the myCIRSE area under CIRSE Academy.

The enrolment period of this course is linked to the validity of the All-Access Pass.

Release date: April 2025