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.