The first endovascular repair of an aortic arch aneurysm in Greece after chronic type A dissection with the Nexus Duo stent graft.
What was the first aortic arch repair in Greece with Nexus Duo?
First endovascular repair in Greece of an aortic arch aneurysm, following chronic type A dissection, with the Nexus Duo endograft. The procedure was performed in the Hybrid operating room of the Athens Medical Center, without sternotomy.
An Nexus Duo is a new-generation branched endograft, designed specifically for the aortic arch: it seals the aneurysm while preserving flow to the branches of the arch. See also the aortic dissection.
What is a chronic type A dissection?
In the aortic dissection the middle layer of the wall separates from the outer layer and a second lumen is created. Type A involves the ascending aorta and the arch, and is treated as a cardiac surgical emergency. Years later, however, the segment that remained dissected can dilate and develop into an aneurysm.
Why is the second operation more difficult?
The patient has already undergone sternotomy and replacement of the ascending aorta. A new open procedure on the arch means repeating the sternotomy through scar tissue, with a significantly increased risk. This is why the endovascular solution has particular value in this group of patients.
What does it mean for recovery?
Because the implantation is performed through a puncture of the femoral artery and without cardiopulmonary bypass, the hospital stay is usually limited to a few days. The exact timing is determined individually by the treating vascular surgeon. See in detail the Nexus Duo endograft.
How is the patient followed up?
After an endograft is placed, lifelong imaging follow-up is required, so that it can be confirmed that it remains in the correct position and that there is no leakage of blood around it. The check is carried out with CT angiography at regular intervals set by the treating doctor. See in detail the endografts and the comparison of endovascular and open repair.
What is the experience with the Nexus system?
Prof. Theodosios Bisdas is among the very few vascular surgeons internationally with experience of first implantations of the Nexus system in three countries: the first in Greece with Nexus Duo, the first in Cyprus with Nexus Tre and the first placement in North Macedonia. See all the pioneering procedures.
