Novel Thoracic Branch Endoprosthesis Expands Options for Complex Endovascular Lesions

Surgical specialists at Orlando Health Heart and Vascular Institute are the first in the region to repair damaged thoracic aortas with the GORE TAG Thoracic Branch Endoprosthesis (TBE). The novel device is designed for endovascular repair of lesions of the descending thoracic aorta while maintaining flow into the left subclavian artery. Since introducing this option in February 2023, Orlando Health has become one of the most experienced centers with this technology in the state of Florida.

Consisting of three implantable, fabric-covered tubes supported by a metal mesh framework, each TBE stent graft has a catheter-based delivery system. The device is permanently implanted inside the thoracic aorta to ease pressure and increase blood flow. The TBE is designed for patients at high risk for debranching subclavian procedures and addresses dissection of the arch and the aorta, aneurysm, pseudoaneurysm or intramural hematoma of the aortic arch and descending thoracic aorta.

“This is an incredibly important tool and technique that allows us to treat very complex pathology with fewer complications, decreased morbidity and faster recovery time for the patient,” says Mohammad Abbasi, MD, a board-certified vascular surgeon with Orlando Health Heart and Vascular Institute. Dr. Abbasi has now successfully completed more TBE cases than any other single provider in Florida.

Thoracic branch endograft with TBE mitigates the need for involved reconstructions of cerebrovascular blood vessels. “Past surgery would have included a bypass from the left carotid to the left subclavian artery, carrying a risk of injury to the phrenic nerve or brachial plexus, chance of stroke or possible lymphatic leak,” says Dr. Abbasi. He specializes in aortic aneurysm repair, minimally invasive endovascular surgery, carotid arterial disease, peripheral arterial disease, and disorders of the venous system and lower extremity wounds.

“Our results treating high-risk patients with more complicated aortic dissection and acute aortic pathologies using TBE has been fantastic,” he says. “As a high-volume center outpacing the region with the complexity of procedures being performed, we are able to bring advanced technology and surgical talent together to perform these operations effectively and efficiently. The support of my cardiothoracic surgery colleagues is critical to our success.”

Orlando Health has long been a regional leader in cardiovascular innovation with experts specializing in more than 40 heart and vascular areas. The highly trained, board-certified cardiovascular and thoracic surgeons at Orlando Health Heart and Vascular Institute are experienced in all aspects of open-heart procedures, including coronary artery bypass, valve repairs and replacements, arrhythmia surgery, adult congenital repairs and complex reoperations.