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Endovascular Aortic Therapy

Modern endovascular treatment for aneurysms and aortic pathology.

The aorta is the largest artery in the body, carrying blood from the heart to every organ. When it weakens and balloons outward (aneurysm), tears along its wall (dissection), or develops complications from prior repair, endovascular treatment can address these life-threatening conditions through small punctures — without the need for major open surgery.

What Is It

Anevrismul aortic este o dilatare anormală a peretelui aortei care, dacă nu este tratat, poate crește în timp și se poate rupe. Disecția aortică apare când straturile peretelui aortic se separă. Tratamentul endovascular (EVAR / TEVAR) introduce o proteză acoperită prin cateter, care „căptușește" aorta din interior și exclude zona bolnavă din circulație.

  • An aortic aneurysm is a dangerous ballooning of the aorta — if it grows too large, it can rupture, which is often fatal
  • Aortic dissection occurs when the inner wall of the aorta tears, allowing blood to split the layers apart — a medical emergency
  • Endovascular repair places a fabric-covered stent graft inside the aorta to reinforce the weakened wall, seal the aneurysm, or cover the tear
  • The device is delivered through catheters inserted in the leg arteries, avoiding the large incisions and prolonged recovery of open surgery

How It Works

Proteza endovasculară este introdusă prin artera femurală (de la inghine), ghidată fluoroscopic până la nivelul anevrismului, unde este eliberată și ancorată. Planificarea 3D pe baza angio-CT este esențială pentru alegerea protezei potrivite și anticiparea dificultăților anatomice.

  • Detailed 3D CT imaging maps the exact shape, size, and anatomy of the aorta before the procedure
  • A custom-sized stent graft is selected or configured to fit the individual anatomy
  • The compressed graft is threaded through the leg arteries and deployed at the target site under X-ray guidance
  • The graft seals off the aneurysm or covers the dissection tear, redirecting blood flow through the new channel
  • Follow-up imaging confirms the seal is complete and monitors for any complications over time

Who Is It For

  • Patients with abdominal aortic aneurysm (AAA) that has grown large enough to require treatment
  • Patients with thoracic aortic aneurysm or selected thoracic aortic pathology
  • Selected aortic dissections where endovascular repair can seal the tear and restore normal flow
  • Patients who have had a prior EVAR or TEVAR and develop complications such as endoleak (blood leaking back into the aneurysm sac)
  • Complex anatomies where the aneurysm involves branches to the kidneys, intestines, or pelvis, requiring advanced techniques to preserve blood flow to these organs

Techniques Used

  • EVAR — endovascular aneurysm repair for abdominal aortic aneurysms
  • TEVAR — thoracic endovascular aortic repair for thoracic aneurysms and dissections
  • 3D CT-based procedural planning for precise graft sizing and deployment strategy
  • Endoanchors (small screws that secure the graft to the aortic wall in anatomies with high migration or seal-failure risk)
  • Chimney and periscope techniques (parallel grafts placed alongside the main stent to keep blood flowing to vital branch arteries)
  • Iliac Branch Devices — IBD (specialized grafts that preserve blood flow to the internal iliac arteries supplying the pelvis)
  • Pelvic circulation preservation strategies to prevent complications like buttock claudication
  • Endovascular management of Type I, II, and III endoleaks (different patterns of blood re-entering the aneurysm sac after repair)
  • Minimally invasive reinterventions for late complications following prior aortic repair
Treating the aorta demands respect for both the disease and the patient. Every aneurysm has a different shape, every dissection a different story. The strategy must be tailored — not just to exclude the aneurysm today, but to ensure the repair remains stable and durable for years to come.