Procedure Offers New Option for Patients with Inoperable Aortic Aneurysms
UW Hospital and Clinics is now offering a new type of minimally invasive procedure for patients with a complex form of abdominal aortic aneurysm.
UW Health vascular surgeon Girma Tefera, MD and associate professor at University of Wisconsin School of Medicine and Public Health, recently completed Wisconsin's first endovascular aneurysm repair (EVAR) using a fenestrated endograft stent. The stents, which were recently approved by the FDA, are designed specifically for patients with inoperable juxtarenal aneurysms- a condition in which the weakened, enlarged vessel wall is close to the renal and superior mesenteric arteries.
Traditional aortic stent grafts cannot be used to treat these types of aneurysms because they restrict critical blood flow to the renal arteries. The new stents are the first in the world to incorporate tailored openings called fenestrations that allow proper blood flow to the kidneys and bowel.
Dr. Tefera says the procedure provides new hope for patients with this previously difficult-to-treat condition.
"This new device allows us to help a population of patients who previously had no options and were facing sudden death from aneurysm rupture," says Dr. Tefera, who underwent six weeks of training to learn how to perform the new procedure. "It's an incredible development for these patients and a major advance in the field of vascular surgery."
During the procedure, doctors use imaging technology to determine where to place the stent and fenestration and then place the device in the aorta, followed by another stent into the renal artery. Each fenestrated device is custom-made to fit patients' unique anatomy.
Like other minimally-invasive endovascular repairs, patients who receive fenestrated endograft stents will generally have shorter hospital stays (typically 48 hours versus five to 10 days), less pain and discomfort, and will usually be able to return to work and normal activity within two weeks, as opposed to 12 weeks after open surgery. Approximately 10-15 percent of all patients with abdominal aortic aneurysms would qualify for the new procedure.