Commentary: Use it or lose it

Central MessageTEVAR is undoubtedly an excellent procedure to save patients with DTAR; however, we should not cling a binary choice and make only between TEVAR open surgery.See Article page 2004. surgery. See The advent of thoracic endovascular aortic repair (TEVAR) has completely changed the therapeutic algorithm for diseases. benefits are less invasiveness rapidity procedure. These features especially helpful in emergent settings. could control lethal bleeding rapidly life patient catastrophic situation. In this issue Journal, Ogawa colleagues1Ogawa Y. Watkins A.C. Lingala B. Nathan I. Chiu P. Iwakoshi S. et al.Improved midterm outcomes after nontraumatic descending rupture compared surgery.J Thorac Cardiovasc Surg. 2021; 161: 2004-2012Abstract Full Text PDF PubMed Scopus (5) Google Scholar report (DTAR). majority were treated by surgery before 2005 2015. Therefore, accurate comparison may be difficult. Further, long-term fate lesion unknown due rather short follow-up period TEVAR. Yet, surgical reported colleagues DTAR congratulated. Perhaps can attributed their superb techniques, but also fine teamwork. A previous describing Jonker colleagues2Jonker F.H. Verhagen H.J. Lin P.H. Heijmen R.H. Trimarchi Lee W.A. al.Open versus ruptured aneurysms.J Vasc 2011; 53: 1210-1216Abstract (80) indicated 15.2% hospital mortality rate TEVAR, which comparable current report. stressed high stroke (7.6%) However, article was 3.8%. my opinion, fact indicates that more accumulated know-how improved outcome. study population included 13 aortobronchial fistula (ABFs) or aortoesophageal fistulas. authors did describe procedures treatments following results minutely; ABF associated risk recurrence ABF.3Canaud L. Alric Gandet T. Albat Marty-Ané C. Berthet J.P. Surgical conversion repair.J 142: 1027-1031Abstract (28) Accordingly, used as bridge definitive repair. Bridging useful adjunct hemorrhagic shock.4Yamazato Nakamura Abe N. Yokawa K. Ikeno Koda al.Surgical strategy treatment fistula.J 2018; 155: 32-40Abstract (21) described there trend toward increased early unplanned reintervention group. about 20%, several reasons reintervention. requiring 50%. point view, I think one options when initial hemostasis obtained DTAR. Although title rupture, enrolled 12 thoracoabdominal aneurysms. been broadly applied diseases, it easily at aorta without major branches. aneurysm requires additional fact, 4 such cases all 3 survivors had chimney/snorkel stent abdominal branch vessels. kind high-tech future direction repair, new technologies still obscure, from complicated approach often these 2 strategies combined properly patients. Improved surgeryThe Journal Thoracic Cardiovascular SurgeryVol. 161Issue 6PreviewThoracic become first-line (DTAR), its remain undescribed. This evaluated whether would improve relative (OSR). Full-Text