Thoracic Endovascular Aortic Repair

Thoracic endovascular aortic repair (TEVAR) is a procedure to treat an aneurysm in

the upper part of the aorta. The aorta is the body’s largest artery. An aneurysm is a
weak, bulging area in the aorta wall. If it bursts (ruptures), it can be deadly.

TEVAR and can be used to address:

• Aneurysm of the aorta

• Separation of one of the aorta’s three layers (dissection)
• Narrowing of the inside of the aorta (stenosis)
• Damage to the aorta from major trauma (transection)

TEVAR is a minimally invasive surgery. That means it is done with a small cut
(incision). With TEVAR, a device called a stent graft is used to reinforce the
aneurysm. A stent graft is a metal tube covered in fabric. It helps prevent the
aneurysm from bursting.

Risks of TEVAR

Some possible complications may include:

• Infection
• Bleeding
• Injury to nearby organs
• Blood clots
• Risks from anesthesia
• Kidney damage from dye used during the X-ray when the stent graft is put in
place
• Device or delivery failure
• Blood vessel injury
• Leaking graft
• Paralysis
• The graft moves out of place
• Loss of a leg
• Traditional open surgery may be needed
• The aortic aneurysm may keep growing after surgery

What happens during TEVAR?

TEVAR is a minimally invasive procedure. This means it is done with a small cut
(incision). A vascular surgeon and a team of specialized healthcare providers will do
the surgery.

This is how it is done:

• Patient will be given anesthesia to prevent pain. This may be general

anesthesia, which causes patient to sleep through the procedure. Or it may be
regional anesthesia, which numbs a certain part of the body.
• Vital signs will be monitored, like the heart rate and blood pressure, during the
procedure.

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• The surgeon may make a small incision in the groin area as well as the arm to
get into the aortic. A thin tube (catheter) called a sheath will be placed in the
artery.
• The surgeon will attach a stent graft to the end of the catheter. The stent graft
is a tube made of a thin metal mesh (the stent). It is covered with a thin
polyester fabric (the graft). The tube is collapsed so it is narrow and can fit
through the blood vessel.
• Using X-rays as a guide, the surgeon will thread the catheter, with the stent
graft attached, through an artery in the groin to the affected part of the aorta.
• Once the stent graft is in place, the surgeon will expand its metal frame and
fasten it into place.
• The metal frame expands like a spring and attaches tightly to the wall of the
aorta. This provides a stable place for blood to flow. It also stops the
aneurysm from bursting. The blood supply is now cut off from the aneurysm.
This makes it shrink over time.
• The surgeon will remove the catheter. He or she will close the incision and put
a small bandage on the wound.

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