TEVAR in Hyderabad | Aortic Aneurysm Repair

Dr Bhishma Chowdary cardiologist in Hyderabad

TEVAR in Hyderabad — Thoracic Endovascular Aortic Repair at Yashoda Hospitals, Hitech City

TEVAR (Thoracic Endovascular Aortic Repair) is a minimally invasive procedure to treat aneurysms, dissections, and other conditions of the thoracic aorta — the section of the body's main artery that passes through the chest. A covered stent graft is delivered through the femoral artery and deployed inside the diseased segment of aorta, excluding it from blood pressure and preventing rupture — all without opening the chest. Dr. Bhishma Chowdary performs TEVAR at Yashoda Hospitals, Hitech City, Hyderabad, offering a dramatically less invasive alternative to open thoracic aortic surgery for suitable anatomy.

At a Glance

Procedure Type	Endovascular aortic intervention — minimally invasive
Conditions Treated	Thoracic aortic aneurysm, Type B aortic dissection, penetrating aortic ulcer, traumatic aortic injury
Access	Femoral artery — typically bilateral
Anaesthesia	General anaesthesia (most cases) or regional/local anaesthesia in selected cases
Duration	1.5 to 3 hours
Hospital Stay	3 to 5 days
Recovery	Walking within 24 hours. Full recovery in 2 to 4 weeks, which is significantly faster than open surgery.
Performed By	Dr. Bhishma Chowdary, DM Cardiology, FSCAI, Yashoda Hospitals, Hyderabad
Appointment	+91-9000352998

Conditions treated with TEVAR

Thoracic Aortic Aneurysm (TAA)	An abnormal bulging of the descending thoracic aorta. Treatment is recommended when the aneurysm diameter exceeds 55 mm, enlarges by more than 5 mm per year, or becomes symptomatic. TEVAR excludes the aneurysm sac from arterial pressure, helping prevent further enlargement and rupture.
Type B Aortic Dissection	A tear in the inner layer of the aorta that begins beyond the left subclavian artery. Uncomplicated cases are usually managed with blood pressure control, while complicated cases involving malperfusion, rupture, or persistent pain require urgent TEVAR to seal the entry tear and restore normal blood flow through the true lumen.
Penetrating Aortic Ulcer	An ulcerated atherosclerotic plaque that penetrates the aortic wall and carries a risk of progressing to aortic dissection or rupture. TEVAR seals the affected segment to prevent further complications.
Traumatic Aortic Injury	A tear in the aorta caused by severe deceleration trauma, such as a road traffic accident. TEVAR is now the preferred emergency treatment because it can be performed rapidly and places less physiological stress on critically injured patients compared with open surgical repair.

Why TEVAR instead of open surgery?

Open surgical repair of the thoracic aorta is one of the most physiologically demanding operations in all of surgery — requiring a large chest incision, cardiopulmonary bypass in many cases, and carrying substantial risk of complications including spinal cord injury (paraplegia), stroke, and death, particularly in older or higher-risk patients.

Chest Incision	TEVAR: No chest incision required. Open Surgery: Requires a thoracotomy, involving a large incision between the ribs.
Physiological Stress	TEVAR: Minimal, as cardiopulmonary bypass is not required in most cases. Open Surgery: Significant, often requiring partial or full cardiopulmonary bypass.
Hospital Stay	TEVAR: 3 to 5 days. Open Surgery: 10 to 14 days, often including an ICU stay.
Recovery	TEVAR: 2 to 4 weeks. Open Surgery: 2 to 3 months.
Spinal Cord Injury Risk	TEVAR: Low, but still present, particularly when long segments of the aorta require stent coverage. Open Surgery: Higher risk and historically a major concern during extensive aortic repairs.
Suitable Anatomy Required	TEVAR requires adequate proximal and distal landing zones for the stent graft to achieve a secure seal. Not all patients have suitable anatomy, so careful assessment with CT angiography is essential before the procedure.

How is TEVAR performed?

Detailed CT angiography of the entire aorta is performed before the procedure to precisely measure the aneurysm or dissection, plan the landing zones for the stent graft, determine the appropriate device size, and select the optimal access approach.
Under general anaesthesia, both femoral arteries are accessed—one for the main stent graft delivery system and the other for angiographic imaging throughout the procedure.
A stiff guidewire is advanced through the aorta under fluoroscopic guidance from the femoral artery across the diseased aortic segment.
The covered stent graft, compressed within a delivery sheath, is carefully advanced to the precise location determined during pre-procedure planning.
Blood pressure is often temporarily lowered using medication during stent graft deployment to minimise the risk of graft movement or migration.
The stent graft is deployed, excluding the aneurysm sac or dissection entry tear from arterial pressure while the metal framework anchors securely to the healthy aortic wall above and below the diseased segment.
Completion angiography confirms that the stent graft is correctly positioned, there is no endoleak around the graft, and blood flow through the aorta and its major branches is preserved.
The access sites are closed, and you are transferred to the intensive care unit for close monitoring, including neurological assessments to evaluate spinal cord function.

Long-term follow-up after TEVAR

Unlike many catheter-based cardiac procedures, TEVAR requires structured long-term imaging surveillance — typically CT angiography at 1, 6, and 12 months, then annually — to monitor for endoleak (persistent blood flow into the excluded aneurysm sac), graft migration, or further aortic changes. This surveillance is a lifelong commitment and is an essential part of the treatment, not an optional extra.

TEVAR near you — serving Hyderabad

TEVAR at Yashoda Hospitals, Hitech City is available for patients across Hitech City, Hitech City, Manikonda, Kondapur, Madhapur, Nanakramguda, Financial District, Jubilee Hills, and across Hyderabad, Telangana and Andhra Pradesh, including urgent cases requiring transfer for aortic dissection or traumatic aortic injury.

Aortic dissection is a medical emergency

Sudden severe tearing chest or back pain, especially radiating between the shoulder blades, requires immediate emergency assessment. Call +91-9000352998 or present to the nearest emergency department immediately.

Frequently asked questions

Is TEVAR a permanent solution?

TEVAR provides durable long-term protection against rupture when the stent graft remains well-sealed, but it requires lifelong surveillance imaging to monitor for endoleak or changes in the graft position. Most patients do not require further intervention after successful TEVAR, but a minority need a secondary procedure over time to address an endoleak or graft-related issue identified on surveillance imaging.

How urgent is TEVAR for a Type B aortic dissection?

This depends on whether the dissection is complicated or uncomplicated. Uncomplicated Type B dissections are typically managed initially with aggressive blood pressure control and monitoring, with TEVAR reserved for those who develop complications. Complicated dissections — with malperfusion to organs or limbs, uncontrolled pain, or signs of impending rupture — require urgent TEVAR, often within hours of diagnosis.

Am I too old for TEVAR?

TEVAR is often particularly well suited to older or higher-risk patients precisely because it avoids the major physiological stress of open thoracic surgery. Age alone is not a barrier — anatomical suitability, assessed on CT angiography, is the primary determinant of candidacy for TEVAR.