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Vascular Disease

Thoracic Endovascular Aneurysm Repair (TEVAR)

What Is TEVAR?

An aneurysm is a weak, bulging area in the aorta, which is the body’s largest artery. Thoracic aortic aneurysms (TAAs) are aneurysms that form in the descending aorta, which extends from the chest to the abdomen. Thoracic endovascular aortic repair (TEVAR) is a minimally invasive procedure used to manage TAAs and aortic dissections. The main purpose of TEVAR is to prevent life-threatening aneurysm complications such as bursting (rupture) and tearing (dissection). TEVAR techniques can also be used in the treatment of thoracoabdominal aneurysms (TAAAs), which extend through the chest and abdominal regions of the aorta.

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During TEVAR, a doctor uses X-ray guidance to implant a stent graft (a fabric-covered, metal-mesh tube) inside the aneurysm to provide reinforcement. The stent is placed using a thin tube (catheter) inserted through femoral artery, through a small incision in the groin. Once the stent is in place, it is expanded to create a stable path for blood to flow. The stent graft reinforces the weakened segment of the aorta to prevent the aneurysm from bursting or tearing.

Who Might Need TEVAR?

If you have been diagnosed with a TAA or TAAA, you may be a candidate for TEVAR. Not all aneurysms require treatment and TEVAR is not suitable for all thoracic aneurysms. Your doctor may consider TEVAR if you have:

  • A thoracic aortic aneurysm that is large or growing rapidly.
  • Type B aortic dissections (tears in the descending thoracic aorta) that cannot be managed with medication therapy alone.
  • An aortic tear due to traumatic injury.

Benefits of Thoracic Endovascular Aneurysm Repair

Benefits of TEVAR include:

  • A success rate equal to that of open surgery for fixing TAAs.
  • Quicker and easier recovery, including less time in the hospital, than open surgery.
  • Lower risk of serious complications or death than open surgery.
  • Does not require a thoracotomy (open chest incision).
  • Less blood loss and pain than open surgery.
  • Lower risk of organ damage caused by reduced blood flow (end-organ ischemia).

Risks of Thoracic Endovascular Aneurysm Repair

Every surgical procedure has some level of risk. Risks of TEVAR include:

  • Endoleak (leaking of blood outside the stent graft and within an aneurysm sac)
  • Infection
  • Movement of the stent graft
  • Leg paralysis (paraplegia) caused by lack of blood flow to the spine (spinal ischemia)
  • Stroke
  • Heart attack

Depending on your condition and general health, you may have other risks. Your provider will discuss the risks of the procedure with you and what can be done to lower them.

Why Choose University Hospitals for TEVAR?

Unparalleled clinical expertise

Highest quality patient outcomes

Office visits and imaging coordinated on the same day

Quick, convenient access with sites across the region

Virtual appointment option for follow up care

What Happens During a TEVAR Procedure?

TEVAR is a minimally invasive procedure that requires only a tiny incision. Prior to the procedure, you will receive medicine to numb the incision area or anesthesia to put you to sleep, depending on your specific needs. Your surgeon will then:

  1. Make a tiny incision in the groin.
  2. Thread a tube (catheter) through the incision into the femoral artery and into your aorta.
  3. Place a stent graft (a thin metal stent covered with fabric) into the catheter and guide it to your aorta with the aid of X-ray imaging.
  4. Uses special tools to expand the stent graft and fix it in place so that blood can flow freely through the aorta and avoid contact with the aneurysm. As a result, the aneurysm will shrink over time.
  5. Remove the catheter and close the incision.

What Happens After TEVAR Surgery?

After the procedure, you will stay in the recovery room for several hours before being moved to a hospital room for continued monitoring. To help prevent bleeding, you may have to lie flat for several hours following TEVAR. If no complications occur, you can expect to stay in the hospital for at least three to four days. You should plan to have an adult family member or friend drive you home when you are discharged from the hospital.