Assistant Professor  |  Associate Member

Miranda Witheford

UHN-Toronto General Hospital
Research Interests
Cardiovascular Systems, Hematology & Circulatory Systems
Research Themes
Cardiovascular, Respiratory, Musculoskeletal
Summer Undergraduate, MSc

Administrative Assistant:

Research Synopsis:

Aortic aneurysms, dilatations of the aorta, the main artery of the body, can be repaired using minimally-invasive stent-based technology that excludes the aneurysm from the circulation, endovascular aortic aneurysm repair (EVAR). EVAR success relies on sealing the aneurysm from the systemic blood pressure to prevent aneurysm rupture, instead of removing the aneurysm entirely. EVARs can be implanted in simple forms with two or three stents, or in complex configurations that incorporate vital arterial beds, such as those that supply the kidneys and bowel. Although EVAR represents a significant technological advancement over traditional open surgery, with greatly reduced perioperative morbidity and mortality, the disadvantage is reduced durability in the long-term, compared with open operation.
EVAR failure represents the convergence of a failure to understand and predict the physical interactions of the aorta and endograft, and the failure to adequately optimize patients, risk stratify, and surveil patients over time. My lab focuses on understanding the interactions of these stent grafts with the aorta over time, and in determining how we can predict their failure a priori. We are also examining the intersections of anatomic-derived EVAR failure with social structures that inadequately optimize patients or inequitably distribute care, resulting in disproportionate impact on disadvantaged populations.