Heart and Vascular Institute on the Forefront of Leading-Edge Treatment for Thoracoabdominal Aneurysms

Lehigh Valley Heart and Vascular Institute is one of the largest heart institutes in Pennsylvania, with dedicated experts treating aortic aneurysms of all types using a multidisciplinary, collaborative approach, explains Benjamin Jackson, MD, Chief, Division of Vascular and Endovascular Surgery.

“We’re able to offer patients the best, safest and most advanced, durable and effective treatment for their aortic diseases,” Dr. Jackson says.

While open surgery remains the best treatment option for some aneurysms, minimally invasive procedures – including branched and fenestrated endografts – offer the benefits of shorter hospital stays and recovery periods for patients for certain clinical presentations.

The complex thoracoabdominal aortic aneurysm (TAAA), which extends from the chest to the abdomen, is one condition that benefits from preservation of blood flow enabled by new multibranch stent grafts.

“There’s a whole revolution in treating TAAAs that’s occurring right now, and we are, in some ways, at the forefront of it,” Dr. Jackson reports.

A multibranch stent graft for the treatment of complex aneurysmal disease involving the visceral aorta, the GORE® EXCLUDER® Thoracoabdominal Branch Endoprosthesis (TAMBE) received FDA approval in 2024 and is now in use at Lehigh Valley Hospital–Cedar Crest.

Aneurysms that exclusively involve the aorta and abdomen are typically treated with either conventional stent grafts or fenestrated stent grafts, Dr. Jackson says, and aneurysms exclusively in the chest are typically treated with straight stent grafts.

“What’s difficult about aneurysms that bridge the two cavities, and therefore cross the diaphragm between the chest and the belly, is that right at or just below the diaphragm are four essential vessels: the arteries supplying blood to the kidneys, the liver and the intestines,” he explains, noting that an unbranched stent graft would interrupt blood flow and result in kidney failure or death from liver and intestinal ischemia.

“Now that we have stent grafts that have branches, we can put [one] in that seals above the aneurysm and below the aneurysm, and then four branches can be used to revascularize the kidney, intestinal and liver arteries,” Dr. Jackson says.

Prior to TAMBE’s approval, standard of care for TAAA was open surgery, or treatment through multibranch stent graft as part of a clinical trial or investigational
device exemption.

The most feared risk of TAAA repair remains interruption of the blood flow to the spinal cord and resulting paralysis. The multibranch stent graft procedure has a lower risk for spinal cord ischemia and paralysis than does traditional open surgery, according to Dr. Jackson.

“We anticipate that this will become standard of care for treating these (TAAAs), and will afford our patients a much safer and less complicated approach to prevent them from rupturing,” he says.