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Baylor St. Luke's Celebrates 20th Anniversary of First Percutaneous Endovascular Abdominal Aortic Aneurysm Repair Procedure

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Houston, TX (June 21, 2016) – This month marks the 20th anniversary of the first-ever percutaneous endovascular aortic aneurysm repair (PEVAR), which was performed at Baylor St. Luke’s Medical Center on June 4, 1996 by Zvonimir Krajcer, MD, Program Director, Peripheral Vascular Interventions, Texas Heart Institute (THI) and Baylor St. Luke’s. Unlike other invasive abdominal aortic aneurysm (AAA) treatments, the percutaneous technique is performed without surgery and under local anesthesia. Over the past two decades, the use of this minimally invasive approach has gained much popularity in the healthcare industry among patients, physicians, and hospitals across the country.

“I’m very proud to see how PEVAR has changed the way physicians approach endovascular aneurysm repair,” said Dr. Krajcer. “Through the partnership between THI and Baylor St. Luke’s, we’ve been able to build upon our legacy in advancing the field of minimally invasive surgery through education and research to modify the treatment of AAA.”

The Evolution of Endovascular Aneurysm Repair (EVAR)

Two of the most common methods of repairing AAAs are traditional open surgery and EVAR. In the surgical procedure, the walls of the aneurysm are replaced with a synthetic graft. This surgical approach requires the use of general anesthesia and an abdominal wall incision, which significantly increase the risk of the procedure and delay the recovery period. During the EVAR procedure, a stent graft is inserted into the aneurysm through small incisions in the groin. Less invasive in technique, EVAR offered patients potentially improved survival rates, reduced recovery times and shorter hospital stays. However, the procedure is still performed at many institutions under general anesthesia, which could have dire side effects on patients with other health issues post-surgery. Also, EVAR often takes place in an operating room, which is typically three to six times more costly for hospitals.

In an effort to further reduce the risks and costs of the procedure, Dr. Krajcer invented a new EVAR technique using the percutaneous approach, which involved no incision, just two small puncture sites in both groins. He also designed a new and smaller graft (14-French or 4.7 millimeter in diameter) in comparison with the previous graft (26-French or 8 millimeter in diameter) to seal off and repair the AAA. He then used the Prostar XL, a suture mediated closure device, to close the femoral artery entry without an incision at the end of the procedure. This technique was performed under local anesthesia in a cardiac catheterization laboratory versus an operating room.

PEVAR’s Proven Success

Since Dr. Krajcer’s first PEVAR at Baylor St. Luke’s in 1996, he has participated as a principal investigator in six EVAR and thoracic aortic aneurysm repair (TEVAR) clinical trials. Multiple studies, such as the recently completed LIFE (Least Invasive Femoral EVAR) Trial, have revealed that the benefits of PEVAR are present across the whole healthcare spectrum, which includes patient, physicians, and hospitals. Patients often experience less pain and discomfort than with traditional EVAR, leading to even faster recovery and no need for narcotic medications. In addition, the procedure is performed under local anesthesia with minimal blood loss and fewer groin-related complications.

For physicians, PEVAR provides patients with a quicker procedure and without the delays that accompany the use of general anesthesia. The approach also leads to improved patient satisfaction and operator efficiency. Hospitals benefits through decreased cost, lower infection rates, less need for blood transfusion, improved efficiency and increased patient satisfaction. The percutaneous method also precludes the use of general anesthetic and need for long hospital length of stay. It decreases operating room times as well. The advances in percutaneous access provide a mutually beneficial approach to endovascular aortic aneurysm repair. Dr. Krajcer has trained more than 1,000 physicians in this minimally invasive technique and performed over 2,000 PEVAR procedures.

“The success rates of the PEVAR and LIFE clinical trials further validate that this minimally invasive technique is not only safer and offers better medical outcomes, but also benefits the hospital from a cost-savings perspective,” said Dr. Krajcer. “I am very proud to see that 70-80 percent of doctors are now using the PEVAR approach.”


About St. Luke’s Health

St. Luke’s Health, a member of Catholic Health Initiatives (CHI), is comprised of three markets?CHI St. Luke’s Health is home of the Texas Heart Institute (THI),  eight hospitals, eight emergency centers, Diagnostic & Treatment Center, Radiation & CyberKnife® Center, and several St. Luke’s Medical Group locations throughout Greater Houston; St. Luke’s Health Memorial (three hospitals and a long-term acute care facility in East Texas); and St. Joseph Health (five hospitals and several St. Joseph Medical Group locations across Brazos Valley). In addition, St. Luke’s is a part of a joint venture agreement with Baylor College of Medicine®, which encompasses Baylor St. Luke’s Medical Center in the Texas Medical Center.  Together, St. Luke’s Health, THI, and Baylor College of Medicine® are transforming healthcare delivery with a mission to usher in a new era of healthcare to create healthier communities. For more information, visit

St. Luke’s Health is a part of Catholic Health Initiatives (CHI), one of the nation’s largest health systems. Headquartered in Englewood, Colorado, CHI operates in 19 states and comprises 105 hospitals, including four academic medical centers and teaching hospitals; 30 critical-access facilities; community health services organizations; accredited nursing colleges; home health agencies; and other services that span the inpatient and outpatient continuum of care. Learn more at

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