Groundbreaking Abdominal Stent Grafting for Aortic Dissection at Kolkata's IPGMER

Time of India

06-05-2025

Patient:
A 66-year-old patient with aortic dissection, a condition where there is a tear in the inner layer of the aorta's wall.
This tear allows blood to flow between the aorta's layers, causing them to separate.
This separation can compromise blood flow to vital organs and potentially cause complications like aortic rupture or cardiac arrest.
Treatment:
Stent grafting via a tiny incision in the groin in a procedure called TEVAR (Thoracic Endovascular Aortic Repair).
In this case, doctors found the femoral artery of the patient was too narrow for the stent grafting.
The team approached the repair route via an incision in the abdomen, making it the first such attempt in eastern India. The patient is recovering well.
TEVAR:
It involves inserting a stent-graft through arteries in the groin.
The stent-graft is guided to the aortic dissection site, where it expands to fit the aorta's shape.
The stent-graft redirects blood flow to the true lumen, reducing pressure on the aortic wall.
KOLKATA: Doctors at the state-run IPGMER (Institute of Post Graduate Medical Education and Research) pulled off a medical feat by deploying an unusual route for stent grafting on a 66-year-old patient with a condition called aortic dissection, a medical emergency.While the patient is recovering well, the IPGMER (SSKM) team is preparing to submit this case to medical journals as the first of its kind, at least in eastern India . This procedure, which costs around 20 lakhs in private hospitals, was entirely funded by the Bengal govt.The patient, Shahamina Bibi , came to the IPGMER with complaints of chest pain. Investigative tests confirmed that she had aortic dissection, a condition where there is a tear in the inner layer of the aorta's wall. This tear allows blood to flow between the aorta's layers, causing them to separate.This separation can compromise blood flow to vital organs and potentially cause complications like aortic rupture or cardiac arrest. It's a medical emergency that can be life-threatening if not treated promptly.While stent grafting via a small incision in the groin is the standard treatment, doctors found that the patient's femoral artery was too narrow, making this traditional route risky. Cardiology and CTVS doctors came together to create an alternative way of grafting the stent by cutting open the abdomen for the procedure known as TEVAR ( Thoracic Endovascular Aortic Repair ).A cardiology team led by Professor Saroj Mandal , with Senior Resident Sayantan Panda , and a CTVS team including Professor Subhendu Mahapatra , came together for the procedure through an incision in the abdomen.'We conduct two to three procedures of stenting for aortic dissection every month, done via the groin. But in this case, the patient's femoral artery was too narrow, making this route highly risky,' said Cardiologist Saroj Mandal .Experts said that when a narrowed femoral artery makes the traditional TEVAR procedure difficult, an abdominal approach is an alternative option. In this case, doctors accessed the aorta directly through an incision in the abdomen to deliver the stent graft needed for repairing the aneurysm in the thoracic aorta.'In this particular case, we had to explore a different access path altogether via an incision on the abdomen to introduce the stent through the device. We completed the procedure uneventfully,' said Mahapatra.The patient is now recuperating well. The doctor team is writing a paper detailing the nitty-gritties of the procedure with the aim of submitting it to a reputed journal.