UNC Aortic Team Performs Successful Endovascular Total Arch Aneurysm Repair
April 12, 2018—UNC Health Care and UNC School of Medicine at the University of North Carolina (UNC) in Chapel Hill, North Carolina, announced the successful completion of an endovascular total arch aneurysm repair that was performed by UNC Health Care's Aortic Team of surgeons, nurses, and technologists. The procedure was made possible through the physician-sponsored investigational device exemption study approved by the US Food and Drug Administration.
Mark Farber, MD, and Thomas Caranasos, MD, conducted a three-vessel endovascular repair of a thoracic aortic arch aneurysm with a custom manufactured device. Dr. Farber is Director of both UNC School of Medicine’s Vascular Surgery Fellowship and its Aortic Program. Dr. Caranasos is Director of Adult Cardiac Surgery at UNC.
According to UNC, this is the first successful procedure of its kind in the United States and has been accomplished a handful of times around the world.
The procedure was performed on April 10 and took approximately 3.5 hours. The 80-year-old patient is recovering well and is scheduled to be discharged on April 13.
In UNC's announcement, Dr. Farber commented, “Procedures of this type would not be possible without all the support from the institution and help of the entire team including the nurses, technicians, physicians, research staff, and everyone else involved with the care of the patient.”
In comments to Endovascular Today, Dr. Farber explained, "The procedure was performed through bilateral common carotid exposures to prevent stroke and a percutaneous femoral access. The main device, which is a custom manufactured three-vessel branch device (a-Branch, Cook Medical), is inserted from the groin. The innominate and left common carotid branches are then implanted via their respective common carotid sheaths and the left subclavian branch is implanted in a retrograde fashion from the femoral position. Deploying the device in the ascending aorta is facilitated by rapid ventricular pacing. The major concern with the treatment of endovascular aortic arch aneurysm is causing stroke during device implantation. The utilization of bilateral carotid exposure during the selective occlusion and control limits the risk of stroke."