Endovascular stenting of thoracic aortic aneurysm was performed for the first time in Macedonia

Stent on an aneurism (more specifically a traumatic transection) of the thoracic aorta was set for the first time in the Republic of Macedonia at Acibadem Sistina Hospital via an endovascular approach. After Prof. Dr. Salis Tadzer performed this intervention, the cardiovascular center at Acibadem Sistina became part of medical reference centers where this intervention is routinely performed.

Advantages of TEVAR regarding classical surgery

Unlike conventional surgery, the TEVAR intervention (Thoracic endovascular aortic repair) is a newer approach for dealing with thoracic aorta aneurysm. According to past experience, the mortality rate is significantly reduced with this intervention and complications are up to 5 times lower compared to classical surgery, where the access to the thoracic aorta is via a large incision on the left side of the chest.

The endovascular approach is performed via a small incision in the inguinal region, where a thin needle, a catheter is inserted through the femoral artery to reach the site of the expansion of the thoracic aorta. Under the control of an X-Ray, stent graft is directly introduced through it in and it is set in the affected part of the aorta. By opening and fixation of the stent, the aneurysm is excluded from the bloodstream and the aorta becomes a smooth tube with normal size. With this intervention, the patient’s recovery is for a shorter period of time and fewer hospital days.

In conventional surgery, the patient is set on extracorporeal circulation with cooling and drainage of the spinal cord and resection of the affected segment of the aorta is cut out. The entire intervention should be strategically and tactically well planned, otherwise the complications are very serious. The most serious complication is paralysis of the lower limbs, which occurs in 15% of the cases.

TEVAR is a routine procedure in reference centers

According to the latest world trends, the problems with the thoracic aorta can be solved with TEVAR, if the conditions are met. In some cases, previous vascular bypass surgery is required so that conditions for TEVAR are set. The joint risk of such planned intervention with 2 procedures is lower than the conventional surgery.

This intervention was performed in 1994 for the first time, it was approved by the FDA in 2005 and since then it is applied in American hospitals. In Macedonia, patients that needed this intervention were referred to the neighboring countries. Acibadem Sistina Hospital is adequately equipped with personnel and technical equipment so that these interventions are routinely performed.

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