Introduction to thoracic endografting: imaging, guidewires, guiding catheters, and delivery sheaths.

Abstract

With the recent approval of the first thoracic endoprosthesis in the United States for the treatment of isolated descending thoracic aortic aneurysms, there has been a dramatic increase in the number of physicians interested in getting involved in this emerging technology. However, many of these physicians do not have extensive endovascular experience, are not familiar with the catheters and guidewires used for thoracic endografting procedures, or do not have access to a full complement of endovascular resources. We discuss the basics of catheters, guidewires, and balloons necessary to perform thoracic endovascular procedures. Adequate radiographic visualization of the thoracic aorta and access vessels is essential for all phases of the thoracic endografting procedure. In addition, a vast array of catheters, guidewires, balloons, and sheaths have been designed to assist with endovascular access and delivery of various therapeutic modalities. Each of the different catheters and guidewires serve an important purpose in the conduct of thoracic endografting procedures, and it is important to have a full understanding of these devices to ensure the best results.