Endovascular Stents For  Thoracic Aortic Aneurysms (TAA)

Endovascular repair may be performed under general, regional or local anesthesia. The procedure typically takes 1 to 3 hours to complete. Patients may have a hospital stay of only a few days and can usually return to normal activity within 2-6 weeks after the procedure.

The endovascular procedure does require regular and routine follow—up visits with your doctor. Tests are performed to evaluate and monitor success of the treatment over time.

Each endovascular graft is compressed into the end of a long, thin, tube—like device called a delivery catheter. The delivery catheter is used to deliver the endovascular graft at the thoracic aortic aneurysm by making a small incision through an artery in the groin. Diagnostic measurements (CT, MRI, and angiography) of the aorta prior to the procedure allow your doctor to visualize the aneurysm and your arteries to select the proper size of endovascular graft.

Procedure

The endovascular graft is implanted using fluoroscopy (real time x-ray images) viewed on a monitor in these steps;

1. A delivery catheter is inserted into the femoral or iliac artery through a small incision (cut) in the groin and carefully guided up the leg artery through the abdomen into the chest (near the heart) to the site of the thoracic aortic aneurysm.

2. Once the endovascular graft is correctly positioned in the aorta (across the aneurysm), it is released or deployed from the delivery catheter.

3. The device self—expands inside the aorta to the diameter of your aorta. The placement of the endovascular graft is designed to exclude off the aneurysm and reline the artery wall.

4. The delivery catheter is withdrawn from the body.

5. Following deployment, an additional step is performed. This step is a ballooning of the device, which aids in sealing/seating of the device in the aorta.

What happens after the procedure?

Currently, follow up is advised to include check ups at 1 month, 6 months, l2 months and annually thereafter. It is very important that you go to all follow up visits recommended by your doctor. The follow up exams will consist of routine x-rays, CT Scans and a physical exam. The exams may also include blood tests and ultrasound or MRI scans if other imaging methods are necessary. These fo1low up exams carry some minimal risk, which should be discussed with your doctor. There is a rare risk of allergic reactions related to the contrast (dye) used in these CT Scans.

These tests and exams are performed because they are necessary in evaluating the outcome of your treatment and any changes over time. Your doctor may also request additional evaluations based on findings at the follow up visits. These may include finding a return of blood flow in the aneurysm and/or growth of the aneurysm. This type and frequency of follow-up visits are generally not required after open surgical repair.

Problems that might happen during the procedure:

The endovascular stent graft procedure is a surgical procedure; as such, there are possible complications associated with the procedure:

1. Vascular complications (for example, blood clot)
2. Neurological complications (for example, stroke or paraplegia)
3. Cardiopulmonary complications (for example, heart attack)
4. Gastrointestinal complications (for example, bowel obstruction)
5. Pulmonary complications (for example, lung damage)
6. Wound healing complications
7. Kidney failure
8. Bleeding
9. Conversion to open surgery
10. Death

Complications related to the graft:

Endovascular stent grafting is a new therapy. Therefore, long term safety has not been established. Possible complications of the device may include, but are not limited to the following:

1. Leaking of blood around the graft (“Endoleak”)
2. Movement of the graft away from the desired location (“Migration”)

What Symptoms Would Prompt you to Call your Doctor?

If you experience any of the following symptoms, contact your doctor immediately:

1. Pain, numbness, coldness, weakness, or loss of sensation in your legs.
2. Any back, chest, abdominal, or groin pain.
3. Dizziness, fainting, rapid heartbeat, or sudden weakness.

What Are the Benefits of a Thoracic Stent Graft Procedure?

There are a number of benefits that are related to having a thoracic stent graft procedure:

1. A lower risk of death compared to open surgery.
2. The patient loses less blood during the procedure.
3. The patient will spend less time in the intensive care unit after the procedure.
4. The patient will have a shorter hospital stay with faster recovery time compared with open surgery