Endovascular Treatment of an Aortic Dissection 

Aortic dissection can be treated through minimally invasive endovascular procedures.    

Endovascular surgery is a minimally invasive treatment for aortic dissection. While some cases of aortic dissection necessitate open-heart surgery, an endovascular approach may be appropriate for tears in certain sections of the artery.  

Conditions Treated   

Aortic dissection means there is a tear inside the wall of the aorta—the body’s largest artery that begins at the heart and splits into the iliac arteries at the lower abdomen. This tear can lead to blood spilling in between the layers of the aortic wall, potentially forcing them apart and increasing the risk of deadly rupture. Because of its possible complications, aortic dissection requires immediate medical treatment.  

Procedure Details     

There are two main types of endovascular aortic dissection surgeries: 

• Thoracic endovascular aortic repair (TEVAR) – Facilitated by detailed moving X-ray images, TEVAR involves feeding a stent through a tiny catheter that is inserted into the femoral artery. This stent is secured once it reaches the site of the dissection, thereby sealing the tear. Additional stents may be inserted to provide further support.  
• Endovascular fenestration – Another catheter-based procedure, endovascular fenestration focuses on equalizing pressure between the layers of the aortic wall (lumens) to reduce the risk of rupture. A stent-supported hole is strategically made in the dissection flap to normalize pressure and improve blood flow.  

What to Expect    

Endovascular aortic repair surgery is typically performed under general anesthesia in a hospital setting. Mild bruising and swelling around the incision site may occur, although this should resolve on its own. It’s important to carefully follow your surgeon’s recovery guidelines following surgery.  

The minimally invasive nature of endovascular surgery means there is less potential for serious complications. However, all medical procedures come with some risk. Although rare, possible complications of endovascular aortic dissection surgery include:  

• Reduced blood supply to the spinal cord  
• Stroke 
• Excess bleeding at the incision site   

Effectiveness   

Aortic dissection is a life-threatening condition that can lead to stroke, organ damage or death if it is left untreated. When a large or growing aortic dissection is identified, aortic repair surgery—whether endovascular or open—is a necessary and life-saving treatment.  

The latest advancements in surgical aneurysm and dissection repair are performed at Tampa General’s Heart & Vascular Institute, where board-certified vascular surgeons help patients achieve world-class outcomes through personalized treatment and state-of-the-art technologies.