Document Management
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Aspect
Medical management:
Medical management:
• Blood pressure
• Heart rate targets
• Urine output
• Anti-impulse medical regimens
• Pain control
Failure to achieve the predefined parameters of medical optimization within 12 hours
should be considered initial treatment failure and escalate the patient to a high-risk
category.
Branch vessel management:
• Management of the arch branch vessels if zone 2 or more proximal aortic arch
coverage is required
• Methods of revascularization
• Type of graft
▶ commercially available graft
▶ investigational branched graft
▶ fenestrated endografts
▶ parallel stent grafts
▶ physician-modified grafts
• Timing related to neurologic outcomes
Adjuncts vs. reintervention vs. planned reintervention:
• Adjuncts are additional maneuvers performed at the time of initial thoracic
endovascular aortic repair (TEVAR)
▶ i.e., Left renal artery stenting, mesenteric artery revascularization, iliac stenting or
femoro-femoral bypass or utilization of a dissection stent
• Reintervention is documented for cases requiring any additional procedures remote
from the initial TEVAR.
▶ i.e., TEVAR extension, false lumen embolization.
• Planned reintervention is where an adjunct is strategically postponed to a later
setting.
▶ i.e., Reentry tear exclusion deferred to a later date
Initial Management Strategy
➤ All aspects of patient management should be reported in a systematic
fashion.
Document Management
