Endovascular repair is minimally invasive surgery to fix an aortic aneurysm or an aortic dissection without open surgery.
Instead of making a large incision, surgeons insert a catheter into an artery in your groin. They then place a stent into the dilated aorta to seal off the aneurysm and prevent further growth or rupture.
Your surgeon may recommend TEVAR (thoracic endovascular aortic repair) if the aneurysm is in your chest.
Our multidisciplinary team aims to provide timely, comprehensive, and individualized disease management strategies for patients suffering from complex thoracic aortic diseases. Learn more about our experts.
TEVAR (thoracic endovascular aortic repair) is the stenting of an aortic aneurysm above the diaphragm.
You will receive general anesthesia for this procedure.
If your surgeon believes you are at high risk for postoperative paraplegia, you may also need a lumbar drain placed in your spinal column. The drain will help protect your spinal cord during and after TEVAR.
Neurophysiology is present for all TEVAR cases. This specialized team checks the motor responses of all extremities during the procedure. If they notice any signs of neurological problems, surgeons can intervene right away.
For thoracic endovascular aortic repairs, your surgeon will:
Your surgeon may use ultrasound with contrast dye, instead of an x-ray, to guide placement and confirm results after the stent is placed.
All surgeries involve risk.
Complications of TEVAR may include:
Recovery time is often shorter with less pain compared to open surgery.
Our surgeons at UPMC are experts in treating thoracic aortic aneurysms and aortic dissections.
A descending thoracic aortic aneurysm is a bulging, weakened area in the wall of the aorta, in the section that runs downward through the chest.
Regardless of your diagnosis, you'll receive the highest quality of care from the UPMC Center for Thoracic Aortic Disease. We work closely with other UPMC experts to offer a complete team approach to treatment.
Your surgeon will plan your aortic aneurysm or dissection treatment based on your:
Treatment may involve either:
If you and your surgeon agree that endovascular repair is the best way to treat your aortic aneurysm, you'll need to prepare.
You'll need pre-op testing including:
Your surgeon will let you know if or when you need to stop taking any medications before surgery.
On the day of your surgery, before going into the OR:
The anesthesia team will put you to sleep using general anesthesia. They will then place a breathing tube down your throat and place you on a ventilator. This machine will breathe for you during surgery.
A nurse will insert a catheter in your bladder.
During TEVAR your surgeon will:
Once your surgeon finishes your operation:
For select patients who have a lumbar drain placed, you will remain in the ICU until the drain is removed.
If you had TEVAR, your total hospital stay will last about a week. During your stay, you'll work with cardiac rehab and physical therapy on walking.
After your endovascular repair surgery:
As you heal from TEVAR you may have:
It's vital to follow your surgeon's instructions during recovery.
You will have your follow-up visit 4 to 6 weeks after leaving the hospital.
You may need to have some tests done before that visit, such as:
If your test results are normal, you can resume driving after this visit. You can also return to work and most other normal activities.
Expect to have your next appointment between 6 and 12 months.
You'll also need to schedule visits with your heart doctor and PCP.