Endovascular stenting and hybrid procedures
Thoracic endovascular aortic repair (TEVAR)
Endovascular repair (also called endovascular stenting) is one of the most recent advancements in aortic surgery. It is used in patients whose anatomy is "favorable"—that is, their aneurysms or dissections do not span any major arteries. The key benefit of endovascular repair is that it is a minimally invasive procedure. Making only a small incision in the groin, a team of surgeons and radiologists can utilize X-ray and ultrasound images to guide a graft-covered stent to the location of the aneurysm. Once the stent is deployed, blood passes exclusively through it, avoiding the aneurysm. A variety of stent-grafts can be used.
Patients who have unfavorable anatomy for stent deployment (an aneurysm involving the visceral arteries or the brachiocephalic arteries) may be candidates for hybrid operations. These operations involve rerouting of the blood supply to the visceral arteries or the brachiocephalic arteries, ligation of the origin of these arteries and stent graft deployment to treat an aneurysm. These innovative techniques have led to a significant simplification of complex aortic problems.