Endovascular Aneurysm Repair (EVAR) with Fenestrated Endograft Stent
UW Health Heart, Vascular and Thoracic surgeons at UW Hospital and Clinics in Madison, Wisconsin, are offering a new type of minimally-invasive procedure for patients with a complex form of abdominal aortic aneurysm.
UW Health vascular surgeon Girma Tefera, MD completed Wisconsin's first endovascular aneurysm repair (EVAR) using a fenestrated endograft stent. The stents are designed specifically for patients with inoperable juxtarenal aneurysms, a condition in which the weakened, enlarged vessel wall is close to the renal and superior mesenteric arteries.
Treating Aortic Aneurysms
Surgeons often treat aortic aneurysms by placing stents - sheaths - inside the vessel to protect it from blood flow that may eventually cause it to burst. Abdominal aortic aneurysms, however, pose a specific difficulty, as they are located near major arteries (the renal and superior mesenteric arteries). Traditional stents cannot be used because these major arteries get in the way of stent placement.
Using a Fenestrated Graft
Custom-made, fenestrated grafts are a solution for the aforementioned problem of stent placement near major arteries. Fenestrated grafts have tailored openings that allow proper blood flow to the kidneys and bowel.
During the procedure, doctors use imaging technology to determine where to place the stent, and then place the device in the aorta, followed by another stent into the renal artery. Each fenestrated device is custom-made to fit patients' unique anatomy.
The Advantages of Minimally-invasive Surgery
- Generally have shorter hospital stays (typically 48 hours versus five to 10 days)
- Experience less pain and discomfort
- Usually are able to return to work and normal activity within two weeks, as opposed to 12 weeks after open surgery
Approximately 10-15 percent of all patients with abdominal aortic aneurysms would qualify for the new procedure.