TEVAR or Thoracic Endovascular Aneurysm Repair is a technique of minimally invasive repair of thoracic aorta diseases like aneurysm, dissection or rupture. It involves lining the thoracic aorta with a stent-graft. A TEVAR is done in a cath lab under x-ray guidance.
Preoperative
You will be subjected to a CT angiogram to assess the suitability for procedure and plan surgery. An anaesthesia consultation may be required and you will be typically admitted to the hospital the evening prior to the procedure.
During the procedure
Anesthesia will be administered as a local injection at your groin or general anaesthesia and this may vary depending on the kind of disease you have.
Small cuts will be made at your groin to access the blood vessels and the procedure will be done through the same.
A Stent Graft ( Metallic Stent lined with fabric) will be inserted through your groin vessels to your aorta.
Post insertion, angiograms are done to confirm correct stent placement and wounds are closed. Patients are typically observed in the ICU after the procedure and shifted toward the following day and discharged in 48 hrs. Wounds require dressing on follow up visits but there is no gross restriction of mobility.
Special procedures associated with TEVAR
Occasionally additional procedures may be done along with a TEVAR due to variations in the patient’s anatomy and disease.
- Hybrid TEVAR – This involves combining a bypass in your neck with a TEVAR. Kindly refer to the section on HYBRID AORTIC Surgery for more details.
- Spinal Catheter insertion – This procedure is done in select patients undergoing TEVAR who are at risk of decreased flow of blood to their spinal column due to the requirement of a long stent-graft placement. This procedure involves inserting a small plastic tube in your back akin to getting spinal anaesthesia and monitoring the pressure in your spinal column via the same. If done the tube is typically removed on the 3rd or 4th postoperative day.
TEVAR is an advanced endovascular modality that offers comparable outcomes to open surgery without the problems associated with it with decreased hospitalization time and early recovery.
