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Physicians at Texas Health Dallas Pioneer Minimally Invasive Techniques to Repair Deadly Aneurysms
06/30/2010

DALLAS — Physicians on the medical staff at Texas Health Presbyterian Hospital Dallas are pioneering new techniques to repair dangerous abdominal aortic aneurysms with minimally invasive techniques that allow patients to go home the next day.

“Of all the things I do as a cardiac surgeon, this is one of the most exciting, most rewarding,” said Dr. James Park, an interventional cardiologist on the medical staff at Texas Health Dallas and medical director of the hospital’s cardiac catheterization laboratory. “It’s a true example of medical advances improving outcomes and helping patients heal faster — with less pain.”

A minimally invasive percutaneous repair of an abdominal aortic aneurysm takes 1-2 hours — and patients go home the next day.
A minimally invasive percutaneous repair of an abdominal aortic aneurysm takes 1-2 hours — and patients go home the next day.

Abdominal aortic aneurysms (AAA), sometimes called triple As, are dangerous bulges in the aortic artery, the major pipeline that supplies blood to the lower half of the body. The walls of the artery are pushed out by blood pressure, making the artery bulge like a weak spot on a worn tire. Because of the large volume of blood that travels through the aorta, a rupture of the aneurysm can be deadly in just minutes.

Traditionally, the way to repair these aneurysms has involved major abdominal surgery, with a long incision down the patient’s stomach. To access the aorta in one of these “open” surgeries, internal organs must be navigated and the patient’s intestines moved outside their body.

But surgeons on the medical staff at Texas Health Dallas are pioneering new ways to treat more and more people with minimally invasive procedures in the hospital’s cardiac catheterization laboratory. The percutaneous (through the skin) procedures involve inserting a tiny wire into the patient’s leg artery and guiding it into the abdomen to the site of the aneurysm. A stent graft is then deployed to give the artery new shape and strength. The aneurysm is stabilized and there is no longer a threat of rupture. Some of these bulges in the artery dissipate over time and simply go away.

The endovascular procedure, which is similar to the way stents are placed inside cardiac arteries to keep blood pumping to the heart muscle, is made even less invasive because of new suturing techniques. As surgeons are removing the wire and sheaths that guide the stent insertion during the procedure, they tie the stitches outside the patient then slide the knot just below the skin surface, where the leg artery was accessed.

“So the incisions we make to access the leg artery and then put the guide wires into the artery are getting smaller and smaller,” said Dr. Russell Lam, an endovascular surgeon on the medical staff at Texas Health Dallas. “It means we can do these much easier than we were once able to.”

A minimally invasive percutaneous repair of an abdominal aortic aneurysm takes 1-2 hours — and patients go home the next day. Traditional open procedures usually require a 4-5 day hospital stay and weeks of recovery.

About abdominal aortic aneurysms
Aneurysms can develop anywhere along the aorta, but most occur in the abdomen. Aneurysms that occur in the upper chest are called thoracic aortic aneurysms. Aortic aneurysms often grow slowly and usually without symptoms, making them difficult to detect. Some aneurysms will never rupture. Others expand at a faster rate, which increases the risk of rupture.

As an aortic aneurysm grows, symptoms may include:

  • A pulsating feeling near the navel
  • Tenderness or pain in the abdomen or chest
  • Back pain

Anyone age 60 and older who has risk factors for developing an aortic aneurysm should consider regular screening for the condition. Men ages 65 to 75 who have ever smoked should have a one-time screening for abdominal aortic aneurysm using abdominal ultrasound. Men age 60 and older with a family history of abdominal aortic aneurysm should also consider screening.

About Texas Health Presbyterian Hospital Dallas
Texas Health Presbyterian Hospital Dallas is an 898-bed acute care hospital and recognized clinical program leader, having provided compassionate care to the residents of Dallas and surrounding communities since 1966. U.S. News and World Report has ranked Texas Health Dallas among the nation’s best hospitals in digestive disorders, orthopedics, and neurology and neurosurgery. An affiliate of the faith-based, nonprofit Texas Health Resources system, Texas Health Dallas has approximately 4,000 employees and an active medical staff of more than 1,000 physicians. For more information, call 1-877-THR-WELL, or visit TexasHealth.org/Dallas.

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