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.