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The aorta is the main artery that carries blood from your heart to all areas of the body. In the abdomen, the aorta divides into the iliac arteries which are responsible for carrying blood to your lower extremities and pelvis. When an aneurysm forms, your blood vessels expand to several times their original size. When left untreated, the artery can burst and often results in death. Aneurysms that occur where the iliac artery branches to the lower extremity and pelvis can be especially difficult to treat and preserve blood flow to the pelvis without open surgery. 

University Surgical Associates (USA) now offers a new minimally invasive treatment for aortoiliac aneurysm that uses a specialized graft to seal off the aneurysm without cutting off blood flow to the pelvis or requiring an open procedure. 

“Aneurysms in the iliac artery typically occur in combination with an aortic aneurysm – they are rarely isolated. Previously, if a stent was placed to treat the aneurysm, an open procedure was almost always necessary to provide blood flow to the pelvis. Another option would be to have another stent placed through the arm and leg and hope that the seal holds together,” says Charles Joels, M.D., vascular surgeon with USA. “Instead of blocking blood flow to the pelvis which can cause pain after surgery, this new device called an iliac branch endovascular graft allows blood to flow to the pelvis and the leg while sealing the aneurysm with a good repair.”   

During the procedure, a delivery catheter is inserted into the femoral artery and carefully guided up the leg artery to the site of the aneurysm. Once the graft is correctly placed in the aorta, the device self-expands inside the aorta to the exact size of your aorta and iliac arteries. The graft seals off the aneurysm and relines the artery wall. Then the catheter is removed from the body. 

“A large percentage of people who lose blood flow to the pelvis will experience pain in the buttock and hip when they walk. The pain generally lessens over time, but it can be debilitating during recovery. When blood flow is hindered in the pelvis, rarely critical organs can die, leading to a life-threatening situation,” says Dr. Joels. “This advanced graft technology creates a new path for treating the aneurysm and allowing blood flow to the pelvis, without the long surgical recovery time.”  

“As of now, we’re fixing more than 90 percent of abdominal aortic aneurysms (AAA) with stent grafts. Many other medical professionals – including anesthesiologists who take care of patients undergoing open procedures – agree that this has been one of the biggest revolutions in healthcare,” says Dr. Joels. “Open procedures required people to be in the ICU for several days and in the hospital for a week or two before a long recovery at home. Now they are getting the repair and going home the next day with similar results and a quick return to normal activities. The benefits are clear.”  

Advanced Care for Aneurysm

Approximately 200,000 abdominal aortic aneurysms are diagnosed each year. People at highest risk for AAA or iliac branch aneurysm are those who are or have been a smoker, and anyone with a family history of aneurysm. This life-threatening condition is often found during an exam for another medical problem or during routine medical screening. Ultrasound is also being used to find aneurysms early when they can be treated more easily. 

For Dr. Joels, staying abreast of new techniques and technologies is part of the overall approach USA surgeons take regarding patient care. “We focus on helping our patients do well. That means being an early adopter of new technology to improve the effectiveness and safety of any procedure,” he says. “Our goal is to have 100 percent of people treated with a lower risk and better recovery.” 

Small aneurysms can be followed and repaired more easily before rupture. If you’re concerned about your risk for aneurysm, talk to your doctor right away to see if you qualify for screening. To schedule an appointment with a vascular surgeon at USA call 423.267.0466.  

A hernia can happen to anyone at any point in their life – and it won’t heal without effective treatment. 

Reports estimate that more than 20 million hernias are treated worldwide every year. When left untreated, a hernia can sometimes cause life-threatening complications including blocked blood flow that leads to strangulation of internal organs. Here are some details you need to know – including when you should have a consult for surgery. 

What is a hernia? A hernia is a hole or defect in the abdominal wall. It can happen at any location of the abdomen. The intestine slides through the muscle and protrudes through, making a bulge under the skin. 

The symptoms for hernias can vary. Many people have no symptoms at all. Others can experience a feeling of burning and sharp pain. Abdominal bloating, nausea, vomiting and constipation could be a sign of an intestinal obstruction, which is a medical emergency. 

How Hernias Happen
Hernias are generally caused by heavy straining and muscle weakness. People who are overweight are at greater risk for developing a hernia because their abdominal pressure is already high. Lifting heavy objects – whether during exercise or when moving into a new house – also increases your risk. 

Other medical issues or activities that may lead to a hernia include: 

  • Straining on the toilet, likely due to constipation
enlarged prostate
physical exertion

  • persistent cough

Most people can see quickly that they have a hernia, although some are less obvious. To officially diagnose the problem, a through physical exam is required. A bulge is often visible to the physician, and occasionally imaging may be necessary. This is more often necessary in people who are obese. 

You might be thinking, why do I need treatment for a hernia if it isn’t causing pain?

It’s true that some hernias don’t need to be treated immediately, especially if they aren’t causing pain. In these cases, doctors may recommend watching and waiting. But for others, there’s a possibility that the hernia could lead to bowel obstruction. Your hernia may or may not get worse – but it’s important to have your hernia evaluated by a surgeon, even if your plan is to hold off on surgery for a while. 

Because surgery is the only way to correct a hernia, several options – including open, minimally invasive and robotic hernia repair – may be considered. Today, most hernias can be treated through minimally invasive procedures that are performed through small incisions in the abdomen, meaning faster recovery and return to normal, daily activities.

If you’ve noticed a bulge in your abdomen, groin pain or felt uncomfortable in your public region while coughing, bending or lifting objects, you may have a hernia. To schedule a consultation with one of USA’s general surgeons, call (423) 267-0466. 

University Surgical Associates (USA) is thrilled to welcome Shana Hilson, MSN, ACNP-BC, CWS, acute care nurse practitioner. Ms. Hilson joins USA with 25 years of nursing experience, including 13 years working in the field of vascular surgery and wound healing. As a certified wound specialist (CWS), Hilson will focus her efforts on treating wounds associated with diabetes, peripheral artery disease, radiation necrosis and lymphedema. 

“The process of wound healing can be difficult and time-consuming, and having a specific focus on wound care is critical to serving the diverse needs of our patients including those who have surgical wounds or who have been living with non-healing wounds that may require longer-term management to see results,” Michael S. Greer, M.D., president of University Surgical Associates. “We’re excited about the expertise that Shana brings and our ability to offer evidence-based and cost-effective management of acute and chronic wounds to our practice. It’s another way we’re expanding our multi-specialty services to help improve the health and quality of life for the patients we serve.” 

Ms. Hilson completed her undergraduate studies at the University of Tennessee at Chattanooga, majoring in criminal justice and psychology. She earned an Associate of Science degree in nursing at Chattanooga State Technical Community College before completing a Bachelor of Science in nursing at Chamberlain University College of Nursing in Downers Grove, Illinois. She then went on to complete a Master of Science in nursing and earn an acute care nurse practitioner certification from Southern Adventist University in Collegedale, Tennessee.

Hilson is certified as a wound specialist by the American Board of Wound Management. She is also member of the Society for Vascular Nursing, the American Academy of Nurse Practitioners, the Emergency Nurses Association, the Sigma Theta Tau Honor Society, and the Chamberlain College of Nursing Honor Society.  

“I’ve always had a particular interest in wound care and the ability to dramatically improve a patient’s life with proper treatment,” says Hilson. “Non-healing wounds can impact many areas of a person’s life – including their mental state and self-esteem. It’s very rewarding to help patients get back to an active and pain-free life.” 

For more information about services available at University Surgical Associates, visit To schedule an appointment, call 423.267.0466.