New Technique to Repair Aneurysms Shows Promise
March 19, 1998
Strong Memorial Hospital has become one of the nation's leading medical centers to test a new, less invasive way of repairing abdominal aneurysms. The Hospital, one of only 20 centers in the country to participate in clinical trials of endovascular grafting, has performed the procedure on 18 patients so far, with promising results.
"Endovascular grafting has the potential to help more than 200 local patients per year to avoid the trauma, risk and cost of major abdominal surgery," said Kenneth Ouriel, M.D., a vascular surgeon at Strong who, along with partner Richard Green, M.D., and radiologist David Waldman, M.D., pioneered the grafting technique. Last summer, the doctors performed the nation's second endovascular graft procedure at Strong.
An aneurysm occurs when a bulge forms on a weakened artery wall. Over time, the bulge can grow dangerously large, and if it bursts, the patient can hemorrhage and die. Traditionally, patients with abdominal aortic aneurysms had to undergo full, open-chest surgery which required a hospital stay of as long as 12 days and an extended recovery.
With the endovascular grafting technique, thin metal tubes known as catheters are entered through small incisions in the groin into the patient's femoral artery. Inside the catheter is a heat sensitive metal sheath covered with polyester. X-ray monitors help the surgeons guide the catheter to the site of the aneurysm. Heat from the patient's body causes the catheter to expand to the size of the vessel, creating a fabric-covered metal sheath that remains behind once the catheters are removed. This sheath, a stent-like implant, reinforces the vessel wall to prevent a future rupture.
The procedure takes less than two hours and patients are generally ready to go home within 1-2 days. If the procedure is successful, patients avoid surgery, but if surgeons are unable to repair the aneurysm using the endovascular technique, traditional surgery is used as a backup. Of the 18 patients to undergo the procedure at Strong, only three required conversion to the traditional procedure. Ouriel and Green expect Strong's results to be published as part the nationwide clinical trial in about a year.
Approximately 110,000 Americans are diagnosed with abdominal aneurysms each year. Once the aneurysm is repaired, as many as 80-90 percent of patients are able to survive a rupture.