PITTSBURGH, March 26, 1998 — Some 15,000 Americans die each year from a ruptured abdominal aortic aneurysm (AAA), which is a ballooning or bulging of the main artery in the abdomen. Left untreated, the aneurysm may rupture unexpectedly and bleed, causing death in up to 80 percent of patients.
In a recent study, surgeons at the University of Pittsburgh Medical Center (UPMC) have found that many patients may benefit from a new treatment for AAA called endovascular surgery.
In endovascular surgery, the aneurysm is repaired from inside the aorta using a catheter instead of through a large incision extending over the entire abdomen.
"This procedure may prove to be safer especially in high risk patients," said Michel Makaroun, M.D., principal investigator in the study, associate professor of surgery and director of endovascular surgery at the UPMC. "Since the endovascular surgery is minimally invasive, it eliminates the need for a large abdominal incision and allows the patient to go home earlier."
Dr. Makaroun presented the results of his study March 28 at the 26th Annual Symposium on Vascular Surgery of the Society for Clinical Vascular Surgery in Coronado, Calif.
In endovascular surgery, a catheter containing a collapsed polyester tube is inserted into the patient’s femoral artery and moved to the site of the aneurysm. Once inside the aneurysm, a spring-type attachment system hooks the tube to the inside walls of the artery on either end of the aneurysm and is anchored into place. Blood then flows through the polyester implant, cutting off the supply of blood to the aneurysm.
The study included 50 patients who underwent the endovascular procedure. Three patients had to be converted to open surgery because of difficulty with the procedure. One high-risk patient had a fatal heart attack three days after surgery.
Almost 90 percent of the patients were discharged within two or three days compared with 5.8 days for open procedure patients. At a mean follow-up of eight months, all of the remaining patients are doing well.
"There have been a few complications but none very serious," Dr. Makaroun said.
"We estimate that we have applied this procedure in one-third of our patients with aneurysms. In the future, new types of devices will allow us to treat up to 70 or 80 percent of patients with this technique."