GE Healthcare Moving beyond EVAR Brochure

GE Healthcare

Moving
beyond
EVAR

Professor Stéphan Haulon
Vascular Surgery Department,
University Hospital of Lille, France

“ We now treat patients with

very advanced disease in very

challenging procedures.”

Everything is moving very fast

A new class of vascular
surgeons is emerging
in aortic repair

Thanks to major advances in the treatment
of large-vessel aneurysms, the movement
to treat vascular abnormalities using
minimally invasive techniques is accelerating.
Abdominal aortic aneurysms (AAA) represent
a genuine unmet medical need, affecting an
estimated 5% of adults over the age of 65
years diagnosed with this life-threatening
condition. Sudden death is nearly certain for
patients in the event of a rupture, whereas
the risk of mortality is reduced to less than
5% in the surgical repair of the aneurysm.

Repair of AAA using catheter­based procedures further improves
a patient’s post-operative recovery
compared to a conventional
intra-abdominal approach in open
surgery. So it is not surprising that
patient demand is a key driver

encouraging the shift to an

intraluminal procedure.

The rapid improvements

and increasing availability
of grafts and advanced
imaging have given
many vascular surgeons

the confidence to adopt the technique, such
that today it is estimated that 33% of AAA is
achieved by endovascular aortic repair (EVAR)
in developed European countries.

Increasing clinical evidence of safety and
effectiveness are also encouraging vascular
surgeons to apply the techniques learned in
EVAR to other procedures. Published papers
describe a clinical practice where boundaries
are dissolving and document the success of
introducing endovascular repair for infrarenal
abdominal aneurysms, thoraco-abdominal
aneurysms, aortic arch aneurysms, and the
ascending aorta using endografts. These
advanced procedures can be complex and
may combine catheter-based techniques with
open surgery to minimize overall invasiveness
and optimize the patient outcome.

As a result of this paradigm shift, a new class
of hybrid vascular surgeon is emerging, one
who is uniquely qualified to introduce the
endovascular techniques of a cath lab as he
also holds the experience and skill to convert
to open surgery in the event of complications.

A pioneer in aortic
aneurysm repair

“I was a resident in 1995 when
everything changed in vascular surgery.
We really invented the first endograft to
repair an abdominal aortic aneurysm in
Lille”, recalls Stéphan Haulon, MD, PhD.

“It was exciting, a completely new
field going beyond conventional
open surgery with planning on 3D
workstations and working with an
imaging system in the OR.”

Internationally recognized as a
pioneer of EVAR Prof. Haulon is also an
established expert for surgical outcomes
for patients after AAA repair as the
author of the new Clinical Practice
Guidelines for the European Society
for Vascular Surgery.

According to the European Society
for Vascular Surgery, Prof. Haulon
convinced fellow cardiac surgeons that
“open surgery is not the gold but the
old standard,” during a debate at the
2010 Joint Session with the Society of
Vascular Surgery.

Based at the academic center
of Lille, Prof. Haulon’s group at the
Cardiovascular Hospital performs
350 aortic repairs each year.