GE Healthcare Moving beyond EVAR - Manual (Page 2)

A new class of vascular
surgeons is emerging
in aortic repair
Thanks to major advances in the treatment
of large-vessel aneurysms, the movement
to treat vascular abnormalities using
minimally invasive techniques is accelerating.
Abdominal aortic aneurysms (AAA) represent
a genuine unmet medical need, affecting an
estimated 5% of adults over the age of 65
years diagnosed with this life-threatening
condition. Sudden death is nearly certain for
patients in the event of a rupture, whereas
the risk of mortality is reduced to less than
5% in the surgical repair of the aneurysm.
Repair of AAA using catheter-
based procedures further improves
a patient’s post-operative recovery
compared to a conventional
intra-abdominal approach in open
surgery. So it is not surprising that
patient demand is a key driver
encouraging the shift to an
intraluminal procedure.
The rapid improvements
and increasing availability
of grafts and advanced
imaging have given
many vascular surgeons
the confidence to adopt the technique, such
that today it is estimated that 33% of AAA is
achieved by endovascular aortic repair (EVAR)
in developed European countries.
Increasing clinical evidence of safety and
effectiveness are also encouraging vascular
surgeons to apply the techniques learned in
EVAR to other procedures. Published papers
describe a clinical practice where boundaries
are dissolving and document the success of
introducing endovascular repair for infrarenal
abdominal aneurysms, thoraco-abdominal
aneurysms, aortic arch aneurysms, and the
ascending aorta using endografts. These
advanced procedures can be complex and
may combine catheter-based techniques with
open surgery to minimize overall invasiveness
and optimize the patient outcome.
As a result of this paradigm shift, a new class
of hybrid vascular surgeon is emerging, one
who is uniquely qualified to introduce the
endovascular techniques of a cath lab as he
also holds the experience and skill to convert
to open surgery in the event of complications.
Everything is moving very fast