Abdominal Aortic Endograft in Nice
Dr. Ilya Khantalin, Vascular Surgeon in the Alpes-Maritimes
Abdominal Aortic Endograft
Dr. Ilya Khantalin in Nice
The aortic endograft—whether positioned at the aortic and/or iliac level, or as part of a more complex procedure requiring a fenestrated endograft—is an innovative and minimally invasive vascular surgery procedure used to treat various aortic pathologies, including abdominal and thoracoabdominal aortic aneurysms as well as aortic dissection.
These procedures, performed by Dr. Ilya Khantalin, vascular surgeon in Saint-Laurent-du-Var, aim to treat aortic abnormalities such as aneurysms or dissections of the abdominal and thoracoabdominal aorta using a less invasive and less traumatic approach than traditional open surgery. This technique restores normal blood flow and helps prevent severe complications such as aneurysm rupture.
Endovascular techniques are now among the most modern and commonly used approaches in vascular surgery, aligned with the guidelines of the Haute Autorité de Santé and integrated into standardized surgical protocols.
Vascular diseases are officially recognized as Long-Term Conditions (Affections de Longue Durée – ALD), allowing for 100% coverage by the French national health insurance.
What is an Aortic Endograft?
Vascular Surgeon in Saint-Laurent-du-Var
An aortic endograft, or stent graft, is a medical device used to treat aortic diseases. It is composed of a cylindrical mesh structure made of composite metal (typically titanium, cobalt, nickel, etc.), which is inserted inside the aorta through a percutaneous or endovascular procedure. This metallic mesh structure reinforces the aorta weakened by abnormal dilations (aneurysms) or restores normal blood flow in cases of aortic dissection.
In vascular surgery, two types of endografts are commonly used to treat the aorto-iliac segment:
- Aorto-bi-iliac Endograft: Used to treat aneurysms or dissections located in the abdominal aorta and iliac arteries. This procedure restores normal blood flow and prevents rupture of the aortic wall.
- Fenestrated Aortic Endograft: A more complex variant used for aneurysms extending into major aortic branches, such as the renal arteries, celiac trunk, or superior mesenteric artery. Fenestrated endografts contain openings (“fenestrations”) to maintain blood flow to these branches while reinforcing the aortic wall.
Indications and Procedure for Abdominal Aortic Endograft Placement
Specialist in Vascular Surgery in Saint-Laurent-du-Var
Indications for Aortic Endograft
Endograft implantation is indicated in several cases, primarily when the aorta presents an aneurysm or dissection that threatens proper circulatory function. The most common indications include:
- Abdominal and Iliac Aortic Aneurysms: An aneurysm is an abnormal dilation of the aortic wall, which can rupture and cause life-threatening hemorrhage if untreated. When the aneurysm exceeds a critical size (e.g., 50 mm in diameter for the abdominal aorta), an endograft becomes necessary to prevent rupture.
- Aorto-Iliac Stenosis: A narrowing of the aorta that can reduce blood supply to the lower limbs, causing pain, claudication, or more severe complications. An endograft can restore normal blood flow.
- Complex Thoracoabdominal Aneurysms: In cases involving both the aorta and its major branches (e.g., renal, celiac, mesenteric arteries), a fenestrated endograft allows for effective treatment while preserving perfusion to vital organs.
- Degenerative Vascular Pathologies: Elderly patients or those with conditions such as atherosclerosis, coagulation disorders, or a family history of aneurysms may benefit from endograft implantation to reduce the risk of life-threatening complications.
Procedure for Endograft Implantation
The procedure is generally performed under local or general anesthesia, depending on the specifics of each case. It is conducted percutaneously—through small incisions in the groin area (inguinal fold)—to access the femoral arteries. A catheter is inserted and guided through the iliac arteries to reach the target site in the aorta.
Using real-time imaging (X-ray, ultrasound, or CT scan), the endograft is precisely positioned and deployed within the aorta. It reinforces the aortic wall, prevents further dilation, and restores normal blood flow.
Postoperative Follow-Up
Follow-up after endograft implantation is essential to ensure long-term success and avoid complications. It includes:
- Short Hospital Stay: Most patients stay in the hospital for only 1 to 2 days, depending on their condition and response to treatment.
- Imaging Surveillance: Regular imaging tests (CT scan, ultrasound) are performed to confirm correct endograft placement, detect potential leaks, and assess blood flow.
- Lifelong Monitoring: Long-term follow-up is mandatory for all patients with an aortic endograft. Annual check-ups and imaging (e.g., Angio-CT of the aorta and lower limbs, twice a year) help monitor the integrity and function of the graft.
- Risk Factor Management: Managing associated risk factors such as hypertension, smoking, diabetes, and hypercholesterolemia is vital to maintaining endograft integrity and preventing recurrence.
The standard or fenestrated aortic endograft represents a major advancement in the treatment of aortic diseases, offering a less invasive alternative to open surgery. As a vascular surgeon in Saint-Laurent-du-Var, Dr. Ilya Khantalin specializes in the placement of aortic endografts for aneurysms, dissections, and complex cases requiring fenestrated devices. Thanks to rigorous follow-up care, this technique ensures patient safety, improves quality of life, and reduces the risk of long-term complications.