UNC Aortic Disease Information for Physicians

About UNC Aortic Disease Management

Aortic Disease Management at UNC Health Care is unique in the Southeast for its comprehensiveness and quality of care. From medical management and minimally invasive procedures to hybrid therapies and open procedures, aortic specialists at UNC provide a complete continuum of care for all types of aortic conditions including aortic dissections, thoracic aortic aneurysms, thoracoabdominal aortic aneurysms (TAAA), abdominal aortic aneurysms (AAA), aortic transections and injuries, mesenteric ischemia and aortoiliac occlusive disease.

UNC is one the leading centers in the Southeast, and one of only a few centers in the entire United States to offer comprehensive minimally invasive treatment of complex aortic disease. At UNC, you will find aortic specialists able to apply cutting-edge minimally invasive treatment that is not available at 99% of centers in the United States. This includes treatment of thoracoabdominal aneurysms (TAAA), which may be performed using fenestrated and branched endovascular repair of aneurysms. Emergent and urgent aortic pathologies including aortic dissections, traumatic aortic transections, and ruptures of thoracoabdominal and abdominal aneurysms may also be treated by minimally invasive techniques. At UNC you will find a 24/7 operating room staff dedicated to treating aortic disease. Aortic specialists work in collaboration with other specialists in interventional radiology and anesthesiology, in determining the best therapy for each patient including participation in clinical trials if eligible. In addition, we have the expertise in hematological (blood) disorders often required for aortic surgery, along with the blood bank resources to cope with its massive transfusion requirements.

UNC also has around the clock transportation by ground or air, with two on-call helicopters for emergencies. Both cardiothoracic and vascular surgery aortic specialists at UNC provide expert professional consultation and treatment for any type of aortic pathology. Our ability to definitively treat all disorders, from the aortic valve to the common femoral artery – whether open or endovascular – is unmatched in the region.

Because of our extensive collaboration, and the breadth of treatment options available here, patients are able to receive the treatment that is personally designed for their unique situation whether it be open, hybrid or a minimally invasive approach.

Aortic Screening

UNC Aortic Disease Management is an ideal choice for aneurysm screening paid for by Medicare as well as private insurers of those over age 50 with familial risk. UNC Health Care has the most advanced diagnostic technologies available, with renowned specialists to interpret testing and explain the results to the patient, then map out treatment strategies for those found to have aortic pathology.

Procedures

  • Endovascular Thoracic Aortic Repair (TEVAR)
  • Endovascular Abdominal Aortic Repair (EVAR)
  • Open Thoracic Aortic Aneurysm Repair
  • Ascending Thoracic Aortic Aneurysm Repair (Endovascular/Open)
  • Surgery to Aortic Arch Vessels (Endovascular/Open)
  • Thoracoabdominal Aortic Aneurysm Repair (TAAA) (Endovascular/Open)
  • Abdominal Aortic Aneurysm Repair (AAA) (Endovascular/Open)
  • Fenestrated Endovascular Repair of Aortic Aneurysms (FEVAR)
  • Branched Endovascular Repair of Aortic Aneurysms (Branched EVAR)
  • Iliac Aneurysm Repair (Endovascular/Open)
  • Juxtarenal Aortic Aneurysm Repair (JRAA) (Endovascular/Open)
  • Suprarenal Aortic Aneurysm Repair (SRAA) (Endovascular/Open)
  • Treatment of Acute and Chronic Aortic Dissections (Endovascular/Open)
  • Treatment of Acute Aortic Injury (Endovascular/Open)
  • Acute and Chronic Mesenteric Ischemia (Endovascular/Open)
  • Aortoiliac Occlusive Disease (Endovascular/Open)

CLINICAL TRIALS

With world-renowned specialists in the treatment of aortic conditions, UNC Health Care leads the way in conducting clinical trials for the advancement of leading-edge aortic treatments. As a result of that commitment to developing new procedures and treatments, 95% of UNC Health Care aortic health patients who require procedures can now be treated with minimally invasive techniques.

These extraordinary advances in endovascular techniques are a major step forward for our patients, who have access to procedures not available in other major medical centers. Patients treated with these minimally invasive procedures are, in general, able to heal faster and with less pain, and return home sooner, with the least disruption to their lives.

Thoracic Aortic Aneurysm Trials

  • A Phase I Clinical Study of the Safety and Performance of the Relay™ Thoracic Stent-Graft in Patients with Thoracic Aortic Pathologies
  • A Phase II Clinical Study of the Safety and Efficacy of the Relay™ Thoracic Stent-Graft in Patients with Thoracic Aortic Pathologies
  • (Valor) Evaluation of the Medtronic Vascular TALENT Thoracic Stent Graft System for the Treatment of Thoracic Aortic Aneurysms (Captivia Delivery System)
  • Evaluation of the Clinical Performance of the Valiant Thoracic Stent Graft System in the Treatment of Descending Thoracic Aneurysms of Degenerative Etiology in Subjects who are Candidates for Endovascular Repair (Valor II)
  • Cook Zenith ®TX2™ THORACIC TAA Endovascular Graft
  • Cook Zenith TX2 Low Profile Stent graft for TAA
  • Zenith TX2 TAA Endovascular Graft Post Approval Study
  • Cook Zenith TX2 Aortic Dissection Trial
  • Evaluation of the GORE Conformable TAG Thoracic Endoprosthesis for Treatment of Traumatic Transections of the Descending Thoracic Aorta (TAG 08-02)
  • Evaluation of the Gore Conformable TAG (CTAG) Endoprosthesis for Treatment of Acute Complicated Type B Aortic Dissection (TAG 08-01)
  • Evaluation of the GORE TAG® Thoracic Endoprosthesis – 45 mm for the Primary Treatment of Aneurysms of the Descending Thoracic Aorta (Protocol Number: TAG 06-02)
  • Evaluation of the GORE TAG Thoracic Endoprosthesis for the Treatment of Complex Pathology of the Descending Thoracic Aorta, Protocol # 04-01
  • Treatment IDE for the Use of the GORE TAG Thoracic Endoprosthesis in Subjects with Descending Thoracic Aortic Aneurysms Requiring Surgical Repair
  • Protocol for high risk patients who require use of a non-FDA approved endovascular stent graft for treatment of thoracic aortic aneurysms in a population that is a high risk for open surgical procedures (TALENT)
  • Evaluation of the Medtronic Vascular TALENT Thoracic Stent Graft System for the Treatment of Thoracic Aortic Aneurysms
  • Evaluation of the Clinical Performance of the Valiant Thoracic Stent Graft System in the Treatment of Descending Thoracic Aneurysms of Degenerative Etiology in Subjects who are Candidates for Endovascular Repair

Abdominal Aortic Aneurysm Trials

  • Zenith Fenestrated AAA Endovascular Graft Study
  • Endologix Fenestrated AAA Endovascular Graft Study (VENTANA)
  • Clinical Investigation Plan for the Zenith Low Profile AAA Endovascular Graft
  • Protocol for high risk patients who require use of a non-FDA approved endovascular stent graft for treatment of infrarenal abdominal aortic and aortoiliac aneurysms in a population that is a high risk for open surgical procedures (TALENT)
  • The Pivotal Study Positive Impact of Endovascular Options or Treating Aneurysms Early
  • A Pivotal Clinical Study to Evaluate the Safety and Effectiveness of the Ovation™ Abdominal Stent Graft System
  • Aptus Endovascular AAA Repair System

Weighing Medical Management vs. Surgery

Despite a diagnosis of aortic disease, not every patient is in immediate need of surgery. In cases where repair of the aortic condition is recommended, the patient's risk factors are evaluated to determine the best method of treatment; minimally invasive endovascular therapy, traditional open surgical repair or a hybrid approach.

Aortic specialists here will try to slow or halt the growth of the aneurysm with medicines for high cholesterol, high blood pressure, or other conditions that may contribute to the risk of aneurysm rupture, then follow the patient's progress closely to adjust treatment as needed. In situations where additional conditions such as heart problems play a role in the patient's heath, aortic specialists will work closely with cardiologists or other experts to help ensure the best possible outcome. At UNC Health Care, the breadth of advanced care resources assures that patients will receive the most appropriate care for their individual condition.

Genetic Testing

In patients suspected of having a genetic reason for their conditions, UNC prescribe testing for two important reasons: First, to make sure that the patient's children are also screened and treated accordingly. And second, because past research has discovered that patients with a genetic component may have more brittle arterial walls than those with sclerotic weakening, so the course of treatment may be affected.

Additional Information & Resources

PHYSICIANS

Mark Farber, MD, Aortic Disease Management Director
Raghuveer Vallabhaneni, MD
Andy Kiser, MD
Peter Ford, MD

 

Referring Physicians

Open Access

Information for Patients