Aortic Arch Endograft in Nice
Dr. Ilya Khantalin, Vascular Surgeon in the Alpes-Maritimes
Aortic Arch Endograft
Dr. Ilya Khantalin in Nice
The treatment of aortic arch diseases represents a major medical challenge due to the complexity and location of this vascular area. The aortic arch endograft is an innovative surgical solution used to treat certain aortic pathologies, such as aneurysms and dissections, while offering a less invasive alternative to traditional open surgery. This procedure involves implanting an aortic stent graft via an endovascular approach, without requiring major incisions.
Endovascular techniques are currently the most modern and commonly employed approaches by vascular surgeons, in accordance with recommendations from the Haute Autorité de Santé and integrated into standardized surgical protocols.
Vascular diseases are recognized as Long-Term Conditions (Affections de Longue Durée – ALD), allowing for 100% coverage by French Social Security.
What is an Aortic Arch Endograft?
Vascular Surgeon in Saint-Laurent-du-Var
The aortic arch is the portion of the aorta that connects the ascending and descending aorta and gives rise to the main arteries supplying the brain and upper limbs. When a pathology affects this area, the use of an endograft becomes necessary to restore vascular continuity.
An endograft is a tubular medical device inserted inside the aorta to reinforce weakened vessel walls. This implant, usually made of metal and covered with synthetic fabric, serves to stabilize the aorta and prevent the progression of conditions such as aneurysms or aortic dissections.
The aortic arch endograft is specifically designed to be inserted via an endovascular route, typically through a puncture in the femoral artery, thus avoiding open-chest surgery.
Indications and Placement Procedure of an Aortic Arch Endograft
Specialist in Vascular Surgery in Saint-Laurent-du-Var
Indications for the Aortic Arch Endograft
Indications for placing an aortic arch endograft are primarily linked to aortic pathologies that require reinforcement of the vessel wall to prevent severe complications such as rupture or dissection. The main indications include:
- Aortic aneurysm: An aneurysm is an abnormal dilation of the aorta, which may lead to fatal rupture if not treated in time. Implanting an endograft in the aortic arch strengthens the aortic wall and prevents rupture.
- Aortic dissection: This condition occurs when the aortic wall tears, creating a space between its layers. An endograft stabilizes the wall and prevents the dissection from progressing.
- Treatment of congenital malformations: Certain malformations of the aortic arch affecting vascular function can be corrected with an endograft to restore normal blood flow.
- Traumatic injuries: In cases of severe trauma to the aortic arch, endograft implantation may be indicated to restore circulation and avoid serious complications.
- Degenerative diseases: Degenerative aortic conditions may weaken the vessel wall, requiring endograft placement to prevent serious medium- or long-term risks.
Placement Procedure
The implantation of an aortic arch endograft is performed under general or local anesthesia, depending on the case. Once the patient is anesthetized, the vascular surgeon introduces the endograft through an endovascular approach, usually via a femoral artery puncture. A catheter equipped with the graft is then guided to the target area of the aortic arch under fluoroscopic imaging.
Once correctly positioned, the graft is deployed and conforms to the shape of the aorta. This procedure stabilizes the affected area without needing to open the chest or abdomen, thereby reducing complication risks and accelerating postoperative recovery.
Postoperative Monitoring of the Aortic Arch Endograft
Follow-up after aortic endograft implantation is essential to ensure proper positioning of the implant and the healthy function of the treated aorta. Postoperative monitoring generally includes:
- Clinical examination: Regular consultations with the vascular surgeon to assess healing and detect any early issues.
- Radiological follow-up: Routine imaging exams (ultrasound, CT, MRI) to monitor the integration of the endograft and rule out complications such as leakage around the graft or infection.
- Assessment of vascular function: Ensuring normal blood flow has been restored and that no additional complications have developed.
- Medication: Anticoagulant or antiplatelet therapy may be prescribed to prevent clot formation near the implant. Adhering to medical prescriptions is vital to minimize complications.
Risks and Potential Complications
While the endovascular approach has many advantages over open surgery, it is not without risks, such as:
- Infection at the access site (femoral artery),
- Misplacement or migration of the endograft,
- Complications related to blood clots or internal bleeding,
- Risk of endoleak, where blood bypasses the graft.
However, with appropriate monitoring and rapid intervention in case of complications, these risks are generally low.
The aortic arch endograft is a major advancement in vascular surgery, offering effective and less invasive treatment for complex aortic conditions. It represents a modern alternative to traditional surgical treatments, with reduced complication rates and faster patient recovery.
Dr. Ilya Khantalin, vascular surgeon in Saint-Laurent-du-Var, is available to provide guidance and rigorous follow-up if you are a candidate for this procedure.
If you exhibit signs of aortic disease or are at risk, do not hesitate to schedule an appointment for a complete evaluation and receive high-quality care tailored to your needs.