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Aortic Surgery Program

 

The aortic surgery program of the Division of Vascular and Endovascular Surgery and University Hospital of Downstate provides treatment for patients with aortic aneurysms, or aortic occlusive disease. We use state of the art imaging equipment with 3-dimensional reconstruction capabilities to diagnose, treat, and follow up our patients after intervention. We bring together a network of dedicated vascular specialists, internists, cardiologists, radiologists, and numerous ancillary faculty to provide comprehensive vascular care.

As part of Department of Surgery at SUNY Downstate Health Sciences University, we are at the forefront of research into the causes, treatments, and prevention of aortic disease.

Conditions we treat

  • Abdominal aortic aneurysms
  • Thoracic aortic aneurysms
  • Aortic dissection
  • Iliac artery aneurysms
  • Aortic artery stenosis or occlusion
  • Iliac artery stenosis or occlusion
  • Intramural hematoma or penetrating atherosclerotic ulcer of the aorta

 

To book an appointment

Call: 718-270-1981

Email: vascular@downstate.edu

Expertise in minimally invasive techniques

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Fenestrated aneurysm repair (FEVAR)

Our aortic surgeons have extensive experience with endovascular, minimally invasive options to treat aortic aneurysmal and occlusive disease. This includes expertise in performing completely percutaneous endovascular aneurysm repair (EVAR). In addition, we have substantial expertise in fenestrated aneurysm repair for juxtarenal abdominal aortic aneurysms; endovascular thoracic aortic aneurysm repair; and branched iliac aneurysm repair.

Around-the-clock coverage

The team is available 24/7 to respond to emergencies like aortic dissections, symptomatic aneurysms, or acute ischemia due to occlusive aortic syndromes.

Comprehensive, collaborative long-term care

As with all types of vascular disease, surgery is only one part of the story when it comes to aortic interventions. Our aortic program is committed to offer long-term follow up across multiple disciplines to assure not only the durability of the repair, but also the appropriate management of co-existent medical conditions that determine long-term complication-free outcomes.

Advanced Aortic Imaging

Accurate imaging is fundamental to establish a diagnosis of aortic disease and determine if and when a procedure is warranted. The Aortic Center features the latest technologies in cardiothoracic imaging, including:

  • Echocardiography: transthoracic and transesophageal
  • CT angiogram: EKG-gated
  • Reconstructed CT angiogram to allow center-line visualization
  • Arterial vascular duplex scanning
  • Intraoperative angiographic 3D-imaging capability

Evidence-Driven Care

We closely track outcomes of our patients after aortic interventions and adjust our techniques to reflect the evolution and technology and new developments in the management of aortic disease. Furthermore, we have actively initiated research projects and published numerous scientific papers on treatment outcomes after aortic interventions.

Selected Publications:

  • Barshes NR, Bidare D, Kougias P, Mills JL Sr, LeMaire SA. Racial and ethnic disparities in abdominal aortic aneurysm evaluation and treatment rates in Texas. J Vasc Surg. 2022 Jan 19:S0741-5214(22)00041-6. doi: 10.1016/j.jvs.2021.12.072. Online ahead of print. PMID: 35063611
  • Anderson PB, Wanken ZJ, Perri JL, Columbo JA, Kang R, Spangler EL, Newhall K, Brooke BS, Dosluoglu H, Lee ES, Raffetto JD, Henke PK, Tang GL, Mureebe L, Kougias P, Johanning J, Arya S, Scali ST, Stone DH, Suckow BD, Orion K, Halpern V, O'Connell J, Inhat D, Nelson P, Tzeng E, Zhou W, Barry M, Sirovich B, Goodney PP; PROVE-AAA Study Team. Patient information sources when facing repair of abdominal aortic aneurysm. J Vasc Surg. 2020 Feb;71(2):497-504. doi: 10.1016/j.jvs.2019.04.460. Epub 2019 Jul 26. PMID: 31353272
  • Columbo JA, Kang R, Spangler EL, Newhall K, Brooke BS, Dosluoglu H, Lee ES, Raffetto JD, Henke PK, Tang GS, Mureebe L, Kougias P, Johanning J, Arya S, Scali ST, Stone DH, Suckow BD, Orion K, Halpern V, O'Connell J, Inhat D, Nelson P, Tzeng E, Zhou W, Barry M, Sirovich B, Goodney PP; PROVE-AAA Study Team. Design of the PReferences for Open Versus Endovascular Repair of Abdominal Aortic Aneurysm (PROVE-AAA) Trial. Ann Vasc Surg. 2020 May;65:247-253. doi: 10.1016/j.avsg.2019.02.034. Epub 2019 May 8. PMID: 3107545
  • Kougias P. Delivering the promise of a minimally invasive thoracoabdominal aneurysm repair: The road less travelled. J Vasc Surg. 2020 Apr;71(4):1413-1414. doi: 10.1016/j.jvs.2019.09.015. PMID: 32204844
  • Sharath SE, Zamani N, Kougias P, Kim S. Missing Data in Surgical Data Sets: A Review of Pertinent Issues and Solutions.. J Surg Res. 2018 Dec;232:240-246. doi: 10.1016/j.jss.2018.06.034. Epub 2018 Jul 13. Review. PMID: 30463724
  • Kougias P, Branco BC, Braun J, Sharath S, Younes H, Barshes NR, Mills JL Sr. Ischemia-induced lower extremity neurologic impairment after fenestrated endovascular aneurysm repair. J Vasc Surg. 2019;70:23-30.PMID: 30626551
  • Pisimisis GT, Kougias P, Barshes NR, Bechara CF. Surgeon-modified fenestrated endograft to treat ruptured juxtarenal aneurysm. JAMA surgery. 2014;149:447-449. PubMed PMID: 24671448
  • Kougias P, Sharath S, Barshes NR, Lowery B, Garcia A, Pak T, Bechara CF, Pisimisis G. Impact of cumulative intravascular contrast exposure on renal function in patients with occlusive and aneurysmal vascular disease. J Vasc Surg. 2014;59:1644-1650. PubMed PMID: 24560864.
  • Bechara CF, Barshes NR, Pisimisis G, Chen H, Pak T, Lin PH, Kougias P. Predicting the learning curve and failures of total percutaneous endovascular aortic aneurysm repair. Journal of Vascular Surgery. 2013;57:72-76 . PubMed PMID: 23127982.
  • Lederle FA, Freischlag JA, Kyriakides TC, Matsumura JS, Padberg FT, Jr., Kohler TR, Kougias P, Jean-Claude JM, Cikrit DF, Swanson KM. Long-term comparison of endovascular and open repair of abdominal aortic aneurysm. The New England Journal of Medicine. 2012;367:1988-1997. PubMed PMID: 23171095
  • Lin PH, Kougias P, Bechara CF, Weakley SM, Bakaeen FG, Lemaire SA, Coselli JS. Clinical outcome of staged versus combined treatment approach of hybrid repair of thoracoabdominal aortic aneurysm with visceral vessel debranching and aortic endograft exclusion. Perspectives in vascular surgery and endovascular therapy. 2012;24:5-13. PubMed PMID: 22316552
  • Kougias P, Lin PH, Dardik A, Lee A, El Sayed HF, Zhou W. Successful treatment of endotension and aneurysm sac enlargement with endovascular stent graft reinforcement. J Vasc Surg, Jul 2007. 46(1):124-7.
  • Kougias P, Peden EK, Lumsden AB. Endovascular management of thoracic aortic aneurysms. Preoperative imaging and device sizing. J Vasc Surg. Feb 2006;43 Suppl A:48A-52A.