title: The role of mandatory lifelong annual surveillance after thoracic endovascular repair.
abstract: Thoracic endovascular aortic repair (TEVAR) has become an attractive and well-accepted option for the management of the various thoracic aortic pathologies that vascular surgeons are confronted with. As in the abdominal aorta, current management trends include the treatment of younger patients with longer life expectancies, raising the issue of postoperative surveillance. There are several relevant differences between these anatomic areas when it comes to surveillance, including the relative inaccessibility of the thoracic aorta to ultrasound interrogation and the increased variability of thoracic aortic pathologies and post-TEVAR complications. In addition, concerns regarding radiation-induced carcinogenesis and contrast-induced nephropathy reduce the enthusiasm of many surgeons for regular computed tomography surveillance. Most agree that surveillance is important after TEVAR, but the method, duration, and frequency of that surveillance is much less clear and is the topic of this debate.
authors.affiliation: Department of Vascular Surgery, Cleveland Clinic Foundation, Cleveland, Ohio 44106, USA.
authors.forename: Shen
authors.initials: S
authors.lastname: Wong
authors.forename: Tara M
authors.initials: TM
authors.lastname: Mastracci
authors.forename: Athanasios
authors.initials: A
authors.lastname: Katsargyris
authors.forename: Eric L G
authors.initials: EL
authors.lastname: Verhoeven
mesh_terms: D017545:Aortic Aneurysm, Thoracic / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D057510:Endovascular Procedures / Q000009:adverse effects; D006801:Humans; D020380:Needs Assessment; D018579:Patient Selection; D011159:Population Surveillance; D012307:Risk Factors; D016896:Treatment Outcome