Fenestrated or Branched Endovascular Aortic Repairs (F/B EVARs) offer a state of the art, minimally invasive approach to treatment of complex aneurysms versus the typical AAA repair.

Our Aortic & Endovascular Surgery team takes a completely customized approach to care with every individual patient. Patients will go through a pre-operative process at our outpatient facility prior to surgery: getting a CT scan, then clinic appointment with one of our physicians to discuss care and treatment. Other services within that building are also easily available and can be handled with ease, for patients that have traveled to Roanoke from out of town.

After these ancillary studies are accomplished between the physician and the patient, a personalized plan is created with next steps and a surgical approach strategy is made.

Once the plan is created, the surgeon builds a customized stent graft for every patient – both fenestrated or branched. These stents allow our team to treat portions of the aorta, including:

• Celiac artery
• Superior mesenteric artery
• Renal arteries
• Aortic arch within the thoracic aorta

Once in the operating room, the team is able to compare the customized stent graft to 3D images, CT scans, and live X-Rays to ensure a proper fit to the patient.

Recovery times for this procedure are significantly quicker versus standard methods: with one-two days in the hospital versus a week or more for standard treatment. After the patient is released from the hospital, all post-operative care is handled in our outpatient center on Carilion’s campus.

It’s important to understand that complex aneurysms are best treated before a rupture. Medicare has approved an abdominal aortic ultrasound for patients with higher risk for abdominal aortic aneurysms, specifically those with a family history of this condition or male patients that have smoked over 100 cigarettes in their lifetime.

For more information on this procedure, click here, or reach out to our team at: 540-853-0100.

TCAR serves as a less invasive alternative to Carotid Endarterectomy, which is the traditional open surgery procedure used to reduce the risk of stroke for Carotid Artery Disease patients. TCAR also provides an opportunity for Carotid Artery Disease patients previously seen as high risk to have a safer surgical care option.

Instead of making a large incision along the artery, TCAR only requires a small incision just above the collarbone. This incision provides direct access to the artery, allowing surgeons to place a specialized sheath into the diseased area. The sheath is connected to a system that reverses blood flow in the artery. This protects the brain from fragments of plaque that may loosen during the procedure. The blood is then filtered and returned through a second sheath to an artery above the thigh. 

Once blood flow is reversed, surgeons deploy a stent in the artery to stabilize any plaque buildup and minimize the potential for a future stroke. After the stent is successfully placed, the blood flow reversal is turned off and blood flow to the brain resumes as normal. Patients are typically out of the hospital by the next day.

For more information on this procedure, click here, or reach out to the Aortic Center at: 540-853-0100