The Aorta is considered a very important artery because it is the channel that carries blood out of the heart to other parts of the body. When the artery leaves the heart, it branches into smaller arteries that send blood to the arms and brain before returning through the back of the chest (thoracic aorta) and then sending blood through the abdominal cavity (abdominal aorta). The aorta artery then branches at the navel area to each leg.
If the wall of the aorta artery bulges abnormally, it will cause weakness in the chest area, known as thoracic aortic aneurysm, which can lead to life-threatening complications. In severe cases, treatment with endovascular graft surgery may be necessary, which must be performed by a specialist, similar to abdominal aortic aneurysm.
What is an Abdominal Aortic Aneurysm?
The condition of ‘Abdominal Aortic Aneurysm’ is an abnormal localized enlargement of the abdominal aorta that is more than 1.5 times its normal size. Normally, the abdominal aorta is about 2 cm in diameter. Therefore, if it is found that the abdominal aorta is larger than normal or about 3 cm, it should be suspected as an ‘aortic aneurysm’.
Endovascular Aneurysm Repair (EVAR) Procedure
Endovascular graft surgery is a popular method because the surgical wound is small and causes less pain compared to open abdominal surgery. It also reduces the use of clamps on the aorta, which can cause blood pressure fluctuations and lead to heart strain, as well as less blood loss than open abdominal surgery.
Thoracic Endovascular Aortic Repair (TEVAR) is a technique used to repair the body’s main artery called the aorta. It is the least invasive procedure because it only requires a small incision to repair the aorta.
Risk Factors Affecting Aortic Aneurysm Problems
- Increasing age
- High blood pressure
- Certain infections
Advantages of TEVAR Surgery
This surgical method helps reduce trauma during the repair of thoracic aortic aneurysms.
Steps of Endovascular Aneurysm Repair
- The surgeon places the device for coil insertion by making a small incision in the groin area.
- Begin inserting a metal mesh stent covered with fabric at the diagnosed position using X-ray guidance.
- Expand the stent to fit the wall of the aorta at the aneurysm site.
- Blood flows through the stent. After treatment, the aneurysm will gradually shrink as blood pressure is diverted away from the aneurysm.
Repairing the affected part of the aorta helps restore normal blood flow to other parts of the body with relatively lower surgical risk compared to other methods.
Candidates for Thoracic Endovascular Aortic Repair (TEVAR)
- Patients with thoracic aortic aneurysm but without rupture, and the size is larger than 5 cm
- Patients with small tears in the thoracic aorta
- Patients with aortic injury
This surgical method results in a relatively small incision, reducing risks and the need for blood transfusion. However, continuous follow-up is necessary because the stent may shift.
Dr. Chayut Cheewapruk
Cardiovascular Specialist
Heart Center, Phyathai Nawamin Hospital
