What is a Thoracic Endovascular Aortic Repair (TEVAR)?

Okay so what is a T-VAR? So a T-VAR stands for thoracic endovascular aneurysm repair and it can be used to treat aneurysms and other aortic syndromes and it's very similar to the EVAR procedure except in some ways it's more straightforward. So generally speaking we gain access through the common femoral artery in the groin and then using fluoroscopy which is live x-ray recording, we then place wires up into the thoracic aorta and then use image guidance to place a stent graft which is constrained within a delivery system, so a kind of a sheath, and that sheath is then advanced up into the aorta to coincide with the position of the pathology which is often an aneurysm. Then we select a stent graft of a certain length which should cover the area of the pathology totally. And then using the X-ray guidance, we then deploy the stent graft. Prior to doing this, we inject some dye, and that tells us that we've definitely got the stent graft in the right position and we're not covering any vital branches of the aorta. And then effectively, the tube then covers the aneurysm, seals it away from the circulation, and then that's the end of the operation. It often takes about 45 minutes depending on the complexity, but it's a straightforward and safe procedure which has pretty much revolutionised the treatment of thoracic aortic pathology which previously had to be performed through large incisions, sometimes putting the patient on to cardiopulmonary bypass.