Aortic aneurysm treatment without surgery

An aneurysm may occur in the chest or the abdomen. They’re usually discovered by chance when your doctor is searching your heart or chest for something else. They may notice a huge throbbing mass in your abdomen that is extremely painful, or they may hear an odd sound while using a stethoscope to listen to your abdomen.







Ask your doctor to calculate the diameter of your aorta if you have a condition like Marfan syndrome, Loeys-Dietz syndrome, or vascular Ehlers-Danlos syndrome, or if aneurysms run in your family. Patients seeking care for abdominal aortic aneurysms may now undergo a repair procedure that does not require a surgical incision.

Boston Medical Center is one of only two locations in Boston providing the non-invasive, incisionless treatment for abdominal aortic aneurysms. The surgeon uses a small puncture site in the skin to patch the artery, eliminating the need for an incision. The patient usually returns home the next day with limited, if any, pain.

The aorta, the largest blood vessel in the chest and abdomen, is dilated in an abdominal aortic aneurysm (AAA). These aneurysms can develop in size and rupture, causing hemorrhage and death. Some AAAs are more difficult than others, affecting the renal arteries as well as intestine arteries. These aneurysms must be repaired openly, with an incision extending from the neck to the groin.

The Advanced Aortic Endovascular Program at UT Southwestern is the region’s only center of excellence with access to these custom-made endovascular aneurysm devices and the expertise to use them on patients. AAA rupture is the 13th leading cause of death in the United States, killing about 15,000 people each year.

Whereas 20% to 30% of patients in most centers are not candidates for endovascular repair, UT Southwestern can repair more than 90% of aortic aneurysms with stent-grafts. Small needle entry points in the groin and a 1-inch incision in the arm are used to deliver these devices. Our Advanced Aortic Endovascular Program currently offers both licensed and investigational devices.

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When parts of the aortic wall collapse and are unable to support the force of blood flow, a bubble forms on the wall. As these bubbles increase in size, they are more likely to burst, resulting in death. Until the late 1990s, when the Food and Drug Administration approved endovascular repair of abdominal aortic aneurysms, aortic aneurysms were treated with a lengthy surgical procedure involving a long abdominal incision. EVAR is a minimally invasive procedure in which surgeons access the aneurysm through a femoral artery incision.

EVAR was first performed through a small puncture site in the skin above the femoral artery in the groin, rather than a surgical groin incision, a few years ago. The graft is then inserted through the puncture site and deployed in the aorta under fluoroscopic guidance. A collection of percutaneously inserted sutures are used to close the opening in the artery. The puncture wound on the skin







Dr. Farber explained that after the graft is released, blood flows into the new graft. “The aneurysm shrinks with time and no longer poses a risk to the patient.”

 

The new technique is ideal for around 80% of patients with an abdominal aortic aneurysm who are examined at BMC. The shape and position of the aneurysm, as well as the amount of calcium ion in the blood, are used by physicians to assess eligibility.

Dr. Farber said, “We have performed incisionless EVAR in ten patients at BMC and have had excellent results.” “However, not everyone is a good candidate for incisionless EVAR. The femoral arteries must be broad enough and the arterial calcification must be minimal.”

Mayo Clinic

Aortic aneurysm treatment without surgery

Aortic aneurysm treatment without surgery