May 8, 2009
“This is a safe and minimally invasive way to treat patients with aortic aneurysms. The recovery time is very short and people can return to their routine very rapidly. We are excited that we can offer this procedure to our Veterans,” said Carlos F. Bechara, M.D., vascular surgeon. Above, Bechara checks on Veteran Alfred Landrum.
HOUSTON - Veterans at the Michael E. DeBakey VA Medical Center (MEDVAMC) now have new technology available for endovascular abdominal aneurysm surgery. Percutaneous (through the skin) endovascular abdominal aneurysm surgery allows these procedures to be done without incisions.
An abdominal aortic aneurysm is an abnormal enlargement or "ballooning out" of the arterial wall of the aorta in a region that passes through the abdominal cavity. Although abdominal aortic aneurysms often do not cause pain; unless treated, an aneurysm may rupture causing a fatal hemorrhage in a patient.
In 1999, an alternative procedure was introduced in the United States called endovascular surgery. The procedure is performed from within the blood vessels using a small incision, one in each groin. A stent covered with fabric is placed at the area of aneurysm and the blood flow is redirected through the stent-graft away from the aneurysm preventing it from rupture. This technology has been shown to be as effective as open surgery with a faster recovery and shorter hospital stay.
Recently, physicians at MEDVAMC have been able to perform these procedures without incisions. A micro-invasive alternative, percutaneous endovascular surgery, for the repair of abdominal aortic aneurysms has become available.
An ultrasound machine is used to visualize and access the groin vessels through the skin. Wires and catheters needed for endovascular repair are inserted through tiny skin nicks over the groin arteries. No large incisions are made. Instead, a microsurgical device is used to insert sutures through the opening into the arteries. After the stent is placed, a special device is used to close the hole in both arteries. This allows patients to recover quickly with minimal pain, and without complications such as fluid collection or infection that are common to groin incisions.
“The percutaneous procedure is streamlined, and is in fact faster than the traditional stent graft operation,” said Grace Campos, RN who works alongside Nida Papa, RN, vascular nurses who are members of the highly skilled surgical team.
“This is a safe and minimally invasive way to treat patients with aortic aneurysms. The recovery time is very short and people can return to their routine very rapidly. We are excited that we can offer this procedure to our Veterans,” said Carlos F. Bechara, M.D., vascular surgeon.
Veterans who were recently treated with the percutaneous method have experienced positive results. “I can’t believe I had an operation because I had no pain at all after the surgery and did not take a single pain pill. I wanted to go home the same day,” said Army Veteran Alfred Landrum.
“I can’t believe it. I went from having a big abdominal incision to a tiny hole in each groin that I can barely see,” said another Veteran.
“It is amazing we can treat this potentially life threatening disease in such a minimally invasive way. Our Veterans can now recover faster and resume their daily activities sooner,” said Panagiotis Kougias, M.D., chief of the MEDVAMC Vascular Surgery Section.
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