Thoracic Endovascular Aortic Repair

June 1, 2023

Thoracic Endovascular Aortic Repair (TEVAR) is a minimally invasive surgical procedure used to treat conditions such as thoracic aortic aneurysms, aortic dissections, and traumatic aortic injuries. TEVAR involves the placement of a stent graft within the aorta to reinforce the weakened or damaged area and restore proper blood flow.

 

Treatments

TEVAR is primarily used to treat thoracic aortic diseases, including aneurysms and dissections. The procedure involves inserting a stent graft, a fabric tube supported by a metal framework, into the aorta through small incisions in the groin or chest. The stent graft provides a new pathway for blood flow, bypassing the weakened or damaged section of the aorta.

 

Before the Procedure

Before undergoing TEVAR, the patient will undergo a thorough evaluation to assess their overall health and suitability for the procedure. This may include medical history review, physical examinations, imaging tests (such as CT angiography), and blood tests. The healthcare team will explain the procedure, discuss potential risks and benefits, and address any concerns.

 

During the Procedure

TEVAR is performed under general anesthesia and typically involves the following steps:

  • Access: Small incisions are made in the groin or chest to access the femoral artery or subclavian artery.
  • Guidewire Placement: A guidewire is inserted through the incision and advanced into the aorta under fluoroscopic guidance.
  • Stent Graft Placement: The stent graft, mounted on a delivery catheter, is threaded over the guidewire and carefully positioned in the diseased portion of the aorta.
  • Deployment: The stent graft is expanded, conforming to the walls of the aorta and sealing off the weakened or damaged section.
  • Blood Flow Restoration: The stent graft allows blood to flow through the aorta, bypassing the aneurysm or dissection, and restoring proper blood flow.

 

After the Procedure

After TEVAR, the patient will be closely monitored in the hospital’s recovery area or intensive care unit (ICU). They may require overnight hospitalization or stay for a few days, depending on their condition. Vital signs, such as blood pressure and heart rate, will be monitored regularly. Pain medication and other supportive measures will be provided as necessary.

 

Advantages

  • Minimally Invasive: TEVAR is a minimally invasive procedure compared to open surgery, resulting in smaller incisions, reduced blood loss, and faster recovery.
  • Reduced Complications: TEVAR carries a lower risk of complications such as infection, organ dysfunction, and respiratory issues compared to traditional open surgery.
  • Faster Recovery: Patients who undergo TEVAR typically experience shorter hospital stays, quicker recovery times, and faster return to normal activities.

 

Risks and Complications

While TEVAR is generally considered safe, there are some potential risks and complications, including:

  • Endoleak: A persistent flow of blood outside the stent graft, requiring additional intervention to prevent complications.
  • Device Migration: The stent graft may move or shift from its intended position, which may necessitate further treatment.
  • Infection: There is a small risk of infection at the incision site or around the stent graft.
  • Vascular Injury: The blood vessels accessed during the procedure may be injured, leading to bleeding or blood vessel occlusion.

 

Typical Recovery Time

The recovery time after TEVAR varies depending on the individual patient and the extent of the procedure. In general, patients can expect to stay in the hospital for a few days and may resume normal activities within a few weeks. However, recovery times may differ based on the patient’s overall health, age, and specific circumstances.

 

Results and Post-Procedure Care

TEVAR has shown positive outcomes in terms of reducing the risk of complications associated with thoracic aortic diseases. After the procedure, post-procedure care may include:

  • Regular Follow-up: Patients will have regular follow-up appointments with their healthcare team to monitor the stent graft’s function and overall recovery.
  • Medication Management: Medications may be prescribed to control blood pressure, prevent blood clots, and manage pain.
  • Lifestyle Modifications: Adopting a heart-healthy lifestyle, including a balanced diet, regular exercise, and avoiding tobacco use, is essential for long-term vascular health.

 

If you have specific concerns about a procedure or your health, please consult a physician.