Aortic stent graft (endovascular aneurysm repair)

An aortic aneurysm is an abnormal swelling of the body's largest artery. As it grows, its wall weakens and may rupture, which is a serious emergency. An aortic stent graft is a synthetic fabric tube supported by a metal frame, placed inside the aorta so that blood flows through the graft and no longer pushes on the diseased wall. The stent graft is introduced folded inside a catheter through the groin arteries, then deployed under X-ray guidance in the catheterisation laboratory. It mainly concerns the abdominal aorta (EVAR) and, in some cases, the thoracic aorta (TEVAR). The procedure is done under general or regional anaesthesia, sometimes local. This technique avoids opening the abdomen or chest and allows a faster recovery than open surgery. It requires suitable anatomy, checked on a detailed CT scan, and lifelong imaging follow-up. For some patients open surgery remains preferable: the choice is discussed case by case. At Clinique Pasteur Tunis, stent grafts are placed by a team combining vascular surgeons and interventional physicians, in a latest-generation catheterisation laboratory, with intensive care on site if needed.