While minimally invasive techniques developed in recent years have greatly improved the safety of surgical treatment of AAA, for many patients – those whose aneurysms are too close to the arteries that feed the kidneys – endovascular graft placement has not been an option because the stent graft itself would block blood flow to the kidneys. These newly FDA-approved devices feature small openings – fenestrations – and can be strategically positioned to allow blood to pass into the renal arteries.
“It’s a significant advantage for us to treat patients with fenestrated devices,” says Luis Sanchez, MD, chief of vascular surgery at Washington University and Barnes-Jewish. “This allows us to treat another 15-20% of patients we would not have been able to treat previously.”
For that 15-20% of patients, surgeons can repair an aneurysm from inside the blood vessel. The stent graft is inserted through an incision in the groin and guided into place using x-ray images.
Dr. Sanchez and his colleagues at Washington University took part in the clinical trial leading to FDA approval. “Results from the U.S. trial have been excellent,” he says. “We found in follow up for five years, no patient required conversion to open surgery and none of the aneurysms ruptured which is ultimately what we want to prevent when we treat these patients.”
The expertise is so deep, Barnes-Jewish Hospital is one of three training sites in the nation to teach the procedure to other surgeons from around the country.
An abdominal aortic aneurysm is a bulge that occurs in the body’s largest artery (the aorta) as it passes through the abdomen. The bulge is caused by a weakening or thinning in the wall of the artery. A synthetic tube-like device (a graft) is used within the blood vessel (endovascular) to treat the AAA by sealing it off.
Rather than traditional open surgery to treat AAA, the less invasive stent procedure allows patients to be discharged in two days with a much quicker recovery time versus a typical hospital stay of 7-10 days with open surgery. The stent grafts are FDA-approved for anyone who is anatomically suitable.
For more information, visit www.barnesjewish.org/aaa or call 866-TOP-DOCS.
Barnes-Jewish Hospital is 1,288 bed teaching hospital affiliated with Washington University School of Medicine in St. Louis, MO. The hospital has a 1,763 member medical staff with many recognized as “Best Doctors in America.” Barnes-Jewish is a member of BJC HealthCare, which provides a full range of health care services through its 13 hospitals and more than 100 health care sites in Missouri and Illinois. Barnes-Jewish Hospital is also consistently ranked as one of America’s “Best Hospitals” by U.S.News & World Report.