Repairing the aorta

Archive, June, Month

Minimally invasive procedure mends alarming aortic aneurysms.

“My cardiologist said, ‘It’s time that we need to do something about this.’”

Ed had been living with some chest pain. He also had some fatigue that would come and go.

It wasn’t something he was overly concerned about, but to be safe, he brought it up with his family doctor.

After some tests, the results were in and a diagnosis was made — Ed had an aortic aneurysm.

A large and critical blood vessel, the aorta carries blood from the heart to the chest, torso and eventually to the rest of the body. An aneurysm is a thinning and ballooning of the blood vessel’s wall.

When he was first diagnosed, Ed’s aneurysm was at 2 cm, large enough for his doctor to take notice and continue to monitor it.

An aneurysm’s growth is aided by blood flow, increasing its potential for rupture.

When his cardiologist checked back on Ed’s aneurysm after some time, it had grown significantly, increasing to 6 cm.

The time had now come to intervene.


A ruptured aneurysm is often fatal. The internal bleeding resulting from a rupture can lead to severe and sudden blood loss, with many dying before even making it to the hospital.

Ed had firsthand knowledge of this reality.

A good friend of his was previously diagnosed with an aortic aneurysm before it ruptured one day. As Ed says, “He’s lucky to be alive” after an emergency chopper flight to a hospital.

For his own troubling aneurysm, Ed was referred to Dr. Joseph Cuppari, a vascular surgeon at McLaren Macomb.

Surgeries exist to repair a growing aneurysm, but traditional procedures are more invasive, with significant soft tissue damage from incisions, adding time to the recovery.

Dr. Cuppari, though, is proficient and experienced with a minimally invasive technique.


“It’s highly favorable to address this condition with a minimally invasive approach,” Dr. Cuppari says, “which allows us to achieve a positive outcome while at the same time avoiding extensive soft tissue damage and a months-long recovery.”

Thoracic endovascular aortic repair, or TEVAR, provides the minimally invasive option for vascular surgeons.

A catheter-based procedure, TEVAR bypasses the need for an incision and any soft tissue disruption. Using advanced imaging technology, a catheter is inserted in the groin and tunneled up to the aneurysm

A stent — a mesh fabric supported by a metallic frame — is then deployed across the neck of the aneurysm, diverting the blood flow that aids its growth and increases its risk for rupture.

Diverting blood flow will support the aneurysm’s safe and natural shrinking over time.

Considering Ed’s case, Dr. Cuppari’s decision was a simple one.

“If we have the option to avoid an open approach in favor of an endovascular procedure, honestly, that decision is an easy one to make,” he said. “It’s beneficial to both the patient and the surgeon.”

Ed was the beneficiary of this approach in his late-January procedure. He avoided a large incision and its potential for blood loss. He avoided the need for post-op pain medication and an extended recovery.

“Right from the beginning,” Ed said, “I was very trusting of Dr. Cuppari.”

After a couple of days of observation, Ed was discharged, and he returned home to continue his recovery.

“Been doing exercises for it,” he said. “Every day gets a little better.