Thoracic endovascular aortic repair (TEVAR) is a medical procedure to treat aortic problems. One of them is an aneurysm in the upper (thoracic) aorta. An aneurysm occurs when the aortic wall weakens and widens or bulges like a balloon. The pressure of blood passing through these weak arteries can cause them to tear and become life threatening because bleeding can occur. TEVAR can also be a way to treat aortic dissection (separation of the layers of the aorta), stenosis (narrowing of the aorta), and transaction (injury to the aorta due to trauma or accident).
TEVAR is classified as minimally invasive surgery, only requiring a small incision to be made during the surgical procedure. In this procedure, the doctor uses a tool called a stent graft to strengthen the aorta again. A stent graft is a tool made of metal material in the form of a tube covered with special fabric. This tool is inserted with a catheter. Its purpose is to support the aorta that has an aneurysm.
TEVAR is the main choice for treating problems with the aorta considering the risks are smaller, compared to surgical procedures, where there are high risks. Patients who undergo TEVAR can recover quickly. Patients can even return to their activities immediately after returning from the hospital.
The TEVAR procedure is carried out with a comprehensive team approach consisting of interventional subspecialist doctors, other related specialist doctors and medical personnel who are competent in their fields. TEVAR's success rate reaches 99% percent.
Objectives of the TEVAR Action
The main aim of the TEVAR procedure is to restore the function of the aorta to circulate blood throughout the body so that the body's systems can return to working normally. The way to do this is to support the weakened aorta so that it doesn't tear or the layers separate. The stent installed in the TEVAR procedure acts as an artificial channel for blood to continue to divert through the aorta. This type of procedure does not require opening any area of the body. Instead, a small incision will be made in the thigh area as access for the procedure. This way, the patient remains free to move after surgery.
Which requires TEVAR Action
TEVAR is often used to treat aortic aneurysms including:
- Atherosclerosis (hardened/narrowed arteries due to fat deposits)
- Vasculitis (inflammation of the arteries)
- Infection of the aorta
- Traumatic injury to the aorta
These risk factors include people with hypertension, smoking habits, old age and unhealthy lifestyles. There are also hereditary factors and certain syndromes that can cause aortic aneurysm. Symptoms of a thoracic aortic aneurysm include:
- Pain in the chest or back
- Shortness of breath during activity
- Frequent coughing
- The voice sounded hoarse
- Tired easily
This article was written by Dr. med. Dr. Yanto S Tjang, SpBTKV, Subsp. VE(K), PhD (Specialist in Thoracic, Cardiac and Vascular Surgery at Grha Kedoya Hospital)