Less invasive surgery for a silent killer: Abdominal aneurysms
Charlie McNeff is crazy about his granddaughter Natalie, which made it all the more difficult when he couldn't celebrate her first birthday with her. For McNeff, however, there wasn't a choice. He needed surgery for an aortic abdominal aneurysm, the size of a small apple, before it ruptured.
What is an abdominal aneurysm?
You could be at risk
An innovative treatment
What is an abdominal aneurysm?
An abdominal aortic aneurysm is a bulge in the main abdominal artery, the aorta, which develops when the wall of an artery weakens. Like a balloon, as the wall of the artery expands, it becomes thinner and weaker until it is so thin that it bursts, causing severe internal bleeding and, in many cases, death.
You could be at risk
While the cause of abdominal aneurysms is still under investigation, researchers are beginning to see a pattern of risk factors. There is a strong genetic component, and it is often associated with people who have vascular disease, fat in the blood stream or who smoke. Virtua endovascular surgeon Charles Field, MD, adds: "There appears to be an imbalance of the composition of the arterial wall itself that leads to a weakness."
The condition develops over many years, usually causing no symptoms until the bulge grows large enough to press on nearby organs or nerves, which can cause severe back pain. More commonly, it is detected during routine physicals or examinations for other conditions. McNeff's showed up on a CAT scan for a gastric ulcer. He was referred to Dr. Field for an evaluation; it was clear that McNeff would need surgery.
An innovative treatment
Fortunately, for McNeff, he was a candidate for an innovative procedure which results in less blood loss, less pain and less healing time than the traditional approach of open surgery. "The conventional repair requires a minimum hospital stay of seven days, 24-hour monitoring, weeks of recovery time, general anesthesia and a large belly incision," explains Dr. Field. "The new technology allows us to repair the aneurysm from the inside, which involves only a small incision, local anesthesia and a few days in the hospital. Seventy-five percent of people who undergo this method are back to their preoperative level within a week."
McNeff says he felt "pretty good" following his surgery at Virtua Marlton, experiencing only minor discomfort in the groin area. "The Marlton nursing staff did everything they could to make me comfortable; Pam was awfully good. After I was released, I only had to take pain medication a couple of times."
The technique begins with a small incision in the groin. The aneurysm is identified by injecting dye into the aorta. A man-made graft is inserted into the aneurysm using a catheter delivery system. The catheter is removed and the graft remains, allowing blood to bypass the aneurysm and flow through the graft into the arteries. "Following surgery, we perform periodic CAT scans to make sure the graft is in position and that the aneurysm has gotten smaller," says Virtua endovascular surgeon Joseph Costabile, MD.
Abdominal aneurysms are generally found in people age 50 and older — the same time the risks associated with general anesthesia increase and other medical conditions begin to develop. Dr. Costabile says: "The new technology can help about 30% of the population. It makes repairing aneurysms less risky for individuals who can't tolerate general anesthesia or the conventional surgical method because of heart disease, emphysema or other chronic conditions. To be considered, however, a person's arteries must be large enough and long enough for the graft to affix itself to them."
This wasn't an issue for McNeff. The anatomy of his arteries and his health were such that he was a perfect candidate. "I'm just about back to normal," he says, "although I haven't tried to lift anything or do anything strenuous." McNeff's plans for the future: "I want to spend as much time as I can with my baby granddaughter. I love my four grandsons, but she stole my heart." Cline earthday edn passport, minable refusal.
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