The first endovascular placement of the Nexus stent graft in Skopje for the endovascular treatment of an aortic arch aneurysm.
What was the first Nexus graft implantation in Skopje?
First endovascular placement in Skopje of the Nexus graft, for the treatment of an aortic arch aneurysm.
Endovascular repair of the Arch Aneurysm is performed with a minimally invasive approach through the femoral artery, without sternotomy, in the hybrid operating room.
What is the Nexus endograft?
This is a branched endograft designed specifically for the aortic arch. It seals the aneurysm while preserving flow to the branches that supply the brain and the upper limbs. Conventional straight endografts cannot be used in this position.
How is it implanted?
Through a puncture of the femoral artery, under continuous imaging guidance, without sternotomy and without cardiopulmonary bypass. The endograft is advanced with catheters to the site of the aneurysm and deployed with millimetre accuracy.
What does it mean for patients in the region?
The application of the technique in Skopje means that cases which in the past would have required transfer to another country can be treated locally, with the collaboration of a specialised surgeon. See the other pioneering procedures.
When does an aneurysm of the arch require surgery?
According to the ESVS guidelines, surgery is considered when the diameter approaches 5.5 centimetres, while in patients with connective tissue disorders the threshold is lower. An aneurysm rarely gives symptoms and is often diagnosed incidentally on imaging carried out for another reason. See in detail the Nexus Duo endograft and the comparison of the two methods.
What is the experience with the Nexus system?
The implantation in Skopje was the third country in which Prof. Theodosios Bisdas performed a first implantation of the Nexus system, after Greece and Cyprus. This is experience that very few vascular surgeons internationally possess, since procedures on the aortic arch are rare and require specialised infrastructure. See also the page on the hybrid operating room.
