New technique provides an alternative to major chest surgery
CHICAGO – Surgeons at Northwestern Memorial aim to determine if stent grafts, a newly developed minimally invasive approach to treating thoracic aortic aneurysms, is as safe and effective as the current standard of care – surgery which requires opening the chest, pulling apart the ribs and replacing the damaged portion of the aorta with a synthetic graft. Northwestern Memorial Hospital is the only hospital in the Chicago area and one of a handful in the country evaluating three different types of stent grafts in separate clinical trials for people with life-threatening thoracic aneurysms.
Stent grafts combine flexible metal scaffolding surrounding a polyester material. They are placed inside the aneurysm -- the abnormal bulging portion of the aorta -- to contain the blood flow and prevent the aneurysm from weakening the aorta wall to the point of rupture. They are placed with specialized catheters that are inserted through arteries at the groin.
Surgeons at Northwestern Memorial began testing the first stent grafts developed about three years ago and have since placed about 35 of these devices. "Although the research has not yet completed, we've had excellent outcomes so far with the stent grafts," says Mark Morasch, M.D., a vascular surgeon at Northwestern Memorial and assistant professor of vascular surgery at Northwestern University's Feinberg School of Medicine. "This is a major advancement in the treatment of a difficult problem. What's more, for patients who are unable to undergo the open chest operation because of the risk involved, stent-grafts may prove to be life-saving."
Open surgery poses risks for serious complications such as paraplegia, stroke and pulmonary failure. It involves an average two-week hospital stay and a two-to-three month recovery period. Conversely, with stent grafts most participants may return home in as little as one or two days following the procedure and resume normal activities within a couple of weeks.
"Being involved in three different manufacturers' trials means we have the ability to choose the best device for people based on their anatomy," says Mark Eskandari, M.D., a vascular surgeon at Northwestern Memorial and assistant professor of vascular surgery at Northwestern University's Feinberg School of Medicine. "The devices vary in size and flexibility and we can tailor-pick the best device for our participants." He adds, "Northwestern Memorial is truly one of the country's leaders in thoracic aneurysm repair because of the vast experience the vascular surgery team has had with a variety of stent grafts.
The aorta is the largest artery in the body and carries the blood that is pumped out of the heart to other organs. It extends from the heart, down through the chest (the thoracic aorta) and into the abdomen (the abdominal aorta). Although not as common as abdominal aortic aneurysm, thoracic aortic aneurysms are diagnosed in an estimated 21,000 Americans each year and the number is rising, possibly due to increased patient access to sophisticated imaging techniques as well as an aging population.
Aneurysms can occur at any age, although they are more common in people who smoke, have a family history of aneurysms and are age 60 and older.
Source: Eurekalert & othersLast reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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