Novel FEVAR surgery done on 67-year-old

Vadodara: A 67-year-old man with an aortic aneurysm (ballooning of the abdominal aorta) successfully underwent fenestrated endovascular aortic aneurysm repair (FEVAR) in the city. The patient had a history of heart and lung problems and altered kidney function, making him a very high-risk individual for open surgery. Originally from Bengal, he settled in the city ten years ago and had an aortic aneurysm for which he was undergoing scans for four years. The aneurysm was increasing in size, after which doctors recommended elective repair. "The minimally invasive option of endovascular aortic aneurysm repair (EVAR) is the modern treatment for aortic aneurysms. It is performed regularly at various vascular surgery centres across India. In this case, it was not feasible as the covered graft would cover both renal arteries and the mesenteric artery, which is a significant supply to the bowel," said Dr Sumit Kapadia. "We went a step ahead and did an innovative FEVAR," said Kapadia, who, along with Dr Vijay Thakore, Dr Hiten Patel, and Dr Kushan Nanavati, executed the on-table fenestration or FEVAR procedure. This novel approach involved precise computerized measurements and the creation of small fenestrations. The entire supra-major procedure was done in the patient via a percutaneous approach using special closure devices in the groin without the need for any major incisions. "The primary graft was positioned across the large aortic aneurysm. Then, by special techniques, three smaller covered stents were passed through the fenestrations into the superior mesenteric artery and renal arteries to maintain blood flow to these organs. The rest of the graft was opened after that to achieve complete sealing of the aneurysm while preserving flow to both kidneys and the bowel," he said, adding that the recovery was speedy, and the patient was discharged within three days recently.