New Procedure Reduces Complications

New Procedure to Treat Abdominal Aortic Aneurysm

For patients with an abdominal aortic aneurysm, there is now hope for repair with a new, less invasive procedure, and a recovery that is more rapid and less painful than standard surgical treatment.

The recently approved Aneurx stent-graft allows elimination of the diseased aorta through two groin incisions. The device is passed up into the aorta through the patient’s own arteries and is one of a new class of devices which define “endovascular surgery.”

“Approximately 70 percent of patients with aortic aneurysms are candidates for treatment with the new stent-graft devices,” says Dr. Peter Schubart, a vascular surgeon at O’Connor Hospital. Dr. Schubart was involved in the FDA trial of the devices and has three years experience in the placement of 150 stent-grafts at O’Connor Hospital and Stanford Medical Center. He now proctors other physicians around the U. S., training them in the techniques used to safely deploy the devices.

“Although these devices are suitable to most patients with abdominal aortic aneurysms, they are particularly useful in high-risk patients with cardiopulmonary disease,” says Dr. Schubart. He points out that in high-risk cases, the devices are deployed using only local anesthesia with gentle sedation. The risk of cardiopulmonary complications and bleeding is greatly reduced compared with open surgical techniques. The procedure is usually completed in two hours and requires no ICU stay. The hospital stay is reduced from one week to two days; recovery time is reduced from six weeks to 10 days.

“Every patient over the age of 60 should be specifically examined for aortic aneurysm, which can almost always be done on physical examination. Aortas suspicious for aneurysms can easily be evaluated by ultrasound, which is noninvasive, inexpensive and painless.”

Once an aneurysm is identified, a spiral CT angiogram in most cases provides all the information necessary to plan for repair with a stent-graft.

The mortality from ruptured aortic aneurysms is 80 percent, compared with a two percent risk of death from surgical repair or stent-graft aneurysm exclusion.