Percutaneous Repair of Abdominal Aortic Aneurysms

Interventional cardiologists and vascular surgeons on the medical staff at Texas Health are pioneering new techniques to repair dangerous abdominal aortic aneurysms with minimally invasive techniques that allow patients to go home the day after surgery. 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 the body.

Today surgeons are treating 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 and disappear 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. A minimally invasive percutaneous repair of an abdominal aortic aneurysm takes one to two hours, and patients go home as soon as the next day. Traditional open procedures usually require a four-to five-day hospital stay and weeks of recovery.

Endovascular Repair of Thoracic Aortic Aneurysms

Physicians on the medical staff at Texas Health are now using minimally invasive techniques to repair deadly aneurysms of the thoracic aorta, the major pipeline leading out of the heart that is responsible for circulating blood throughout the body. Because the aorta carries such a high volume of blood, the rupture of an aneurysm, which is similar to a bulge in a bicycle tire, can be deadly in just minutes. Today surgeons can repair these aneurysms by deploying a graft through a tiny catheter, giving the aorta structure and stability and eliminating the possibility of a deadly rupture. Traditional open surgery to implant the synthetic graft is a high-risk procedure, but surgeons can now place the stent over the aneurysm using endovascular techniques. The procedure involves placing a tiny wire called a catheter into the patient's leg artery and guiding it to the site of the aneurysm. Patients typically go home in one to two days and can resume full activities within several weeks.

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