TECH. COMPARISON / Advantage of TEVAR
Thoracic aortic aneurysm
The development of endovascular stent graft surgery of thoracic aortic aneurysms avoid both painful and high risk than the conventional open surgery , this procedure is one of endovascular surgery. Conventional open surgery usually separate, cut and suture a large vessel by large chest incision, which often requires extracorporeal for the heart and blocks the blood flow for some time to the aorta in order to proceed the surgery.
Advanced endovascular surgery proceed via wires, catheters and stent graft into vessels, and complete the treatment by angiography, so there is no actual vessel peeling or sewn, the advantages for endovascular surgery are small wounds, less blood loss, less pain and quicker recovery time.
There are advantages to treating thoracic aortic aneurysm with endovascular stent graft compare with conventional open surgery. First of all, the wounds on both sides of thigh are small (even if vessel closure is used, there is no need to deal with surgical incisions) and no longer be a need for a more than thirty centimeters chest incision, so, of course, after the surgery, the recovery time considerable progress, is no longer the same as the conventional open surgery to stay ICU for a few days. In general, patients can be discharged on the same day or a few days after surgery, not like patients who need two weeks for more frequently hospitalized when they have conventional open surgery of aortic.
Secondly, the amount of blood loss during surgery, surgery-related cardiopulmonary complications, hemiplegia, and surgery-related mortality also have significant differences.
Using endovascular stent graft does not require clamping the entire aorta, hemodynamic does not change much and less stressful for cardiopulmonary system, so it is much easier for cardiopulmonary function to recover after the surgery, and because the entire procedure are completed in the vessel lumen, it minimize the impact for the rest of the body.
Surely not all thoracic aortic aneurysms patients are suitable for endovascular stent graft. In this stage, aneurysms in aortic arch, and descending aorta are suitable for stent graft. Cardiovascular Surgery specialists need the complete diagnostic assessment of location, pattern and diameter of vessels to determine if it is appropriate to adopt of the surgery.
The most important consideration for patients who adopt this advanced technology is to be checked regularly, pay close attention to the size of aneurysm and location of stent graft for a certain period. In case there is displacement which needs to enhance fixation via endovascular surgery.
Note: thoracic aortic stent graft is covered by the health insurance but not vascular closure system.
According to the domestic regulations, only qualified cardiovascular surgeons are allowed to perform this surgery independently!