NYU Medical Center Performs its First Microinvasive Repair Procedure for Abdominal Aortic Aneurysms
A minimally invasive alternative for the repair of abdominal aortic aneurysms (AAA) is now available at NYU Medical Center. This procedure is performed by a team of highly trained endovascular surgeons and interventional radiologists.
An abdominal aortic aneurysm is a swelling of a weakened area of the aorta, the main blood vessel that carries blood away from the heart to the rest of the body. If left untreated, an AAA can burst and, when it does, is fatal in 80-90% of cases.
Conventionally, an AAA has been repaired through full abdominal incision. A graft is inserted, allowing the blood to pass through the graft, keeping the blood from pulsating against the weakened aorta wall.
The last decade has seen an increase in the use of a minimally invasive technique for AAA treatment using endovascular repair. With this approach, a graft supported by a metal stent is inserted in the aneurysm without the need for a full abdominal incision. However, this technique still requires incisions over the groins to surgically expose the groin arteries.
In the newer procedure, percutaneous (“through the skin”) endovascular repair, no large incisions are made. Instead, a catheter is inserted through tiny skin incisions over the groin arteries. A stent graft is directed through the catheter to the aneurysm, creating new walls in the blood vessel for blood to flow through and thereby avoiding pressure on the swelling. The openings in the groin arteries are then sealed with a microsuturing technique to complete the procedure.
In addition to being less invasive than conventional endovascular repair and virtually bloodless, in some patients this form of endovascular repair may have a lower risk of complications. Patients who undergo percutaneous endovascular repair may have a lower risk of fluid accumulation around the groin areas from the buildup of lymph or serum.
For more information on this procedure, please contact the Division of Vascular and Interventional Radiology, (212) 263-5898, or the Division of Vascular Surgery, (212) 263-7311.
When an abdominal aortic aneurysm is repaired using a stent graft, either through traditional surgery or through percutaneous repair, it is critical to know whether it results in a significant reduction in the amount of blood flow in the aneurysm outside the stent graft. Typically, imaging technologies such as CAT scan or MRI have been used to determine the success or failure of endovascular repairs of AAA.
Recently, a new technology manufactured by Cardio-Mems has become available to measure the success of aneurysm repair. A miniature implantable device sits in the aneurysm sac and measures the pressure inside the aneurysm. When the blood pressure in the aneurysm drops, this signifies that the stent graft is functioning well. The Division of Vascular Surgery at NYU Medical Center has successfully implanted this new technology and has found great success in being able to monitor these aneurysms without CAT scan or MRI.
Posted: 4/3/08