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Aortic Surgery
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Aortic Surgery Program
Aortic Surgery Endovascular Aortic Repair

Treating Complex Arch and Thoracoabdominal Aneurysms with Stents

Until recently, operations on the aortic arch required two operations, performed six weeks apart. With the advent of endovascular techniques, the two procedures can be combined into a single operation. According to Dr. Takayama, the new hybrid procedure, which combines an open procedure with endovascular repair, significantly shortens the length of aortic arch surgery and reduces the adverse effects associated with these operations. The procedure takes place in our new, state-of-the-art hybrid operating room. This room is featured in our recently opened heart hospital, which is attached to the main hospital.

TOTAL ARCH REPLACEMENT VIDEO: TOTAL ARCH REPLACEMENT

Length3:38 min
Download Flash Player Flash Player Required

The availability of new fenestrated grafts provides less invasive options for patients with aneurysms located close to the kidneys, which would otherwise require open surgery. For all patients, and especially elderly patients who might be ineligible for surgery, endograft repair may provide a far safer and less traumatic alternative to open surgery. These catheter-based procedures are usually performed under local anesthesia by a multidisciplinary team including vascular surgeons, interventional cardiologists, and cardiac surgeons. Potential benefits of the procedure include less risk, shorter hospital stay, and more rapid recovery, compared to open-heart aneurysm repair.

In this minimally invasive procedure, a stent graft (comprised of a layer of impermeable reinforcement material enclosed by a self-expanding metal support mesh) is placed at the aneurysm site. To implant the stent graft, the physician inserts a catheter through the femoral artery in the groin. The stent graft is then delivered through the catheter in a collapsed state and deployed at the site of the aneurysm. The device replaces and reinforces the diseased aortic wall, ensuring continuity of blood flow. The benefits of the procedure include greatly reduced risk, a shorter hospital stay, and a more rapid recovery.

NewYork-Presbyterian-Columbia participates in the Bolton-RELAY stent graft clinical trial.

Endovascular Stent Graft Aneurysm Repair VIDEO: Endovascular Stent Graft Aneurysm Repair
View an animation of insertion of the GORE TAG® Thoracic Endoprosthesis Treatment Option for a Thoracic Aortic Aneurysm
Length1:46 min
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Columbia University Medical Center NewYork-Presbyterian Hospital Patient Clinician Researcher