January 2, 2014
|Dr. Panos Kougias (left) and Dr. Carlos Bechara examine Navy Veteran Robert Eddleman during his follow-up visit at the VA.
Photo by: Fran Burke
Surgeons at the Michael E. DeBakey VA Medical Center (MEDVAMC) recently performed successful groundbreaking minimally invasive vascular procedures on two military Veterans. The surgeons performed the City of Houston’s first implantations of a new type of stent graft, called a fenestrated endograft. Each stent graft (the Zenith Fenestrated AAA Endovascular Graft by Cook Medical) is custom-made from a 3-D computer model of the patient's anatomy, which is based on a spiral CT scan. Holes, or fenestrations, are positioned in the stent graft precisely where the patient's renal or bowel arteries branch off, ensuring that blood can flow to the kidneys and nearby organs from the aorta.
“My primary care physician in Shreveport, La., ordered a routine ultrasound to check my cardiovascular health. I was shocked when an aneurysm was found,” said Navy Veteran Robert Eddleman. “I had absolutely no symptoms.”
In about 10 percent of patients with an abdominal aortic aneurysm, the defect in the aorta wall occurs very close to the arteries that branch off to the kidneys. Treatment of an aneurysm in this location is complex and often requires open surgery to repair the weakened wall.
The vascular surgery team at MEDVAMC, comprised of surgeons, surgical nurses and anesthetists, successfully implanted the ZFEN endograft during a minimally invasive procedure. “There is a lot of planning and preparation that goes into these operations prior to the patient going into the operating room,” said Panos Kougias, M.D., chief of Vascular Surgery at MEDVAMC and an Associate Professor of Surgery at Baylor College of Medicine (BCM).
“Knowing the stent graft and patients anatomy, we bridged the two fenestrations (holes) with two stents to preserve flow to both kidney arteries and at the same time exclude the aneurysm,” said Carlos Bechara, M.D., M.S., staff vascular surgeon and also an assistant professor of Vascular Surgery and Endovascular Therapy at BCM. “Both patients went home within a few days and were able to resume their daily activities in comparison to weeks of recovery after open aneurysm repair.”
“I feel really good. I don’t have a six month recovery period. I am five weeks post-surgery, and I have no surgical issues and no specific restrictions,” said Eddleman. “The doctors are amazing here.”
“We constantly strive to open new doors and make new minimally invasive alternatives available for our Veterans. The fact that vascular surgeons at the MEDVAMC were elected as the first team in the entire city to have access to the first ever commercially available fenestrated endograft speaks volumes about the skill of our vascular surgery team and the quality of care it provides,” said Samir Awad, Operative Care Line executive and professor in the Michael E. DeBakey Department of Surgery at BCM.