Thoracic endovascular aortic repair is a minimally invasive procedure used to treat certain conditions affecting the aorta within the chest, including thoracic aortic aneurysm, aortic dissection and traumatic aortic injury. Tampa General Hospital offers TEVAR as part of a full range of vascular surgery services for patients throughout Brooksville, Spring Hill, Crystal River and surrounding communities. Procedures are performed at TGH Brooksville, with diagnostic assessments, treatment planning and continued vascular monitoring conveniently available throughout the area.
What Is Thoracic Endovascular Aortic Repair?
TEVAR uses a stent graft placed inside the thoracic aorta to reinforce a damaged or weakened section of the artery and create a secure pathway for blood flow. The thoracic aorta is the section of the body’s largest artery that travels through the chest, carrying blood from the heart to other areas of the body. Disease or injury can compromise this portion of the aorta, potentially interfering with healthy blood flow and increasing the risk of serious complications.
Thoracic endovascular aortic repair is a catheter-based procedure used primarily to treat conditions involving the descending thoracic aorta. Rather than reaching the affected area through a large chest incision, the vascular surgeon will advance a stent graft through the blood vessels and position it inside the thoracic aorta. Once in place, the graft will help redirect blood through the treated section while reducing stress on the affected area.
How Does a Thoracic Aortic Stent Graft Work?
A thoracic aortic stent graft is a fabric-covered metal framework designed to support the aorta from within. During the TEVAR procedure, the vascular surgeon will deliver a compressed graft through a catheter, which is typically inserted into an artery near the groin. Advanced imaging will allow the vascular surgeon to guide the device through the blood vessels and precisely place it within the thoracic aorta.
Once properly positioned, the graft will expand and attach to the healthy sections of the aorta above and below the affected area. Depending on the condition being treated, the graft may redirect blood away from an aneurysm, help seal a tear in the aortic wall or reinforce a section of the artery damaged by trauma.
Because important arteries branch away from the thoracic aorta to supply blood to the brain, spinal cord and other parts of the body, careful imaging and procedural planning are essential when determining where the stent graft can be safely placed.
What Conditions Can Be Treated With Thoracic Endovascular Aortic Repair?
TEVAR can be used to treat several serious conditions affecting the thoracic aorta. Whether endovascular repair is appropriate depends on the type and location of the disease or injury as well as the patient’s individual anatomy.
Conditions that may be treated with TEVAR include:
- Thoracic aortic aneurysm – A thoracic aortic aneurysm occurs when a weakened section of the aorta within the chest enlarges or bulges outward. TEVAR may be used to reinforce certain aneurysms, particularly those involving the descending thoracic aorta, to reduce the risk of rupture.
- Aortic dissection – An aortic dissection occurs when a tear in the inner layer of the aortic wall allows blood to flow between the layers of the wall. In certain dissections involving the descending aorta, a stent graft can cover the tear and redirect blood through the normal channel of the artery.
- Traumatic aortic injury – A traumatic aortic injury occurs when the thoracic aorta is damaged by severe trauma, such as a direct impact, high-force collision or fall. TEVAR may provide a minimally invasive way to rapidly reinforce the injured area and reduce the risk of life-threatening bleeding.
When Is Thoracic Endovascular Aortic Repair Recommended?
TEVAR may be performed as a planned procedure for progressive thoracic aortic disease or as an urgent or emergency intervention for certain acute conditions. The decision will depend on the diagnosis, the severity of the condition and the risk of complications without treatment.
For a thoracic aortic aneurysm, factors such as the aneurysm’s size, growth rate, location and shape will be considered along with the patient’s symptoms and overall health. For aortic dissection or traumatic injury, the extent and location of the damage, blood flow to important organs and the risk of rupture may influence how quickly intervention is needed.
Anatomy also plays an important role in TEVAR eligibility. The vascular surgery team will perform a thorough evaluation to determine whether there are suitable areas of healthy aorta where a stent graft can be securely placed and also consider the location of nearby arterial branches. Planning may include strategies to protect blood flow to the brain and spinal cord.
In some cases, open thoracic aortic surgery or another treatment approach may be more appropriate than TEVAR. Each recommendation is based on a careful assessment of the potential benefits and risks for the individual patient.
How Does Thoracic Endovascular Aortic Repair Differ From Open Thoracic Aortic Surgery?
Both TEVAR and open thoracic aortic surgery can be used to treat serious conditions affecting the thoracic aorta, but the procedures access and repair the artery differently.
Open surgery typically requires a large incision in the chest or the side of the body to allow the surgeon to directly reach and repair the affected portion of the aorta. TEVAR approaches the thoracic aorta from inside the blood vessels, generally through a small incision or puncture near the groin.
For an appropriately selected patient, avoiding a large chest incision may mean less tissue disruption, a shorter hospital stay and a faster initial recovery. However, TEVAR is not appropriate for every thoracic aortic condition or anatomy. Open repair may still be recommended if it offers a safer or more durable solution.
What Is Recovery Like After Thoracic Endovascular Aortic Repair?
Recovery after TEVAR is typically shorter than recovery after traditional open thoracic aortic surgery. However, the length of the hospital stay and overall recovery period can vary depending on the condition treated, whether the procedure was planned or performed as an emergency, the complexity of the surgery and the patient’s overall health.
After leaving the hospital, the patient may gradually return to their normal routines, including work, exercise and other daily tasks, according to their vascular surgeon’s instructions.
Recovery from TEVAR also includes ongoing management of aortic health. The patient should attend all recommended appointments and follow their healthcare team’s instructions on controlling blood pressure and addressing other cardiovascular risk factors that could affect the aorta over time.
What Are the Risks of Thoracic Endovascular Aortic Repair?
Although TEVAR is less invasive than open thoracic aortic surgery, it is still a major vascular procedure with potential risks. Possible complications include:
- Bleeding or blood vessel injury
- Infection
- Blood clots
- Kidney problems related to the contrast dye used to visualize the blood vessels
- Endoleak, allowing blood to continue flowing outside the stent graft into the treated area
- Movement of the stent graft
- Stroke
- Reduced blood flow to the spinal cord, which can cause neurological complications
The likelihood of these complications can vary based on the location and extent of the aortic disease or damage, the complexity of the procedure and the patient’s anatomy and overall health. Careful planning and monitoring can help the vascular surgery team identify and manage these risks.
Why Is Long-Term Follow-Up Imaging Important After Thoracic Endovascular Aortic Repair?
Treatment does not end after the patient has recovered from the TEVAR procedure. Long-term surveillance imaging will be essential for monitoring both the stent graft and the thoracic aorta.
Follow-up imaging will allow the vascular surgery team to confirm that the graft remains securely positioned and continues to function as intended. It can also identify endoleaks, changes in the size or shape of the aorta, progression of aortic disease and other concerns that may require closer monitoring or additional treatment.
Because changes can occur without noticeable symptoms, the patient should continue with their recommended imaging schedule even if they feel well. The vascular surgery team will determine the appropriate type and frequency of imaging based on each patient’s condition and previous findings.
Consult With Our Vascular Surgery Services Team
If you have been diagnosed with a thoracic aortic aneurysm, aortic dissection or another condition affecting the thoracic aorta, Tampa General Hospital’s vascular surgery servicesteam can evaluate your condition and determine whether TEVAR, open surgery or another treatment approach may be appropriate.
TEVAR and other vascular procedures are performed at TGH Brooksville, with evaluations, treatment planning and ongoing follow-up available to patients throughout Brooksville, Spring Hill, Crystal River and surrounding communities. Contact Tampa General Hospital to schedule a consultation or learn more about treatment for thoracic aortic disease. We have been ranked No. 1 in the Tampa Bay region for Cardiology, Heart & Vascular Surgery by U.S. News & World Report for 2026-27.