January 20, 2004
Veteran Mike Westberry asks Peter Lin, M.D., chief of the MEDVAMC Vascular Surgery Section and Ruth Bush, M.D., MEDVAMC vascular physician a few questions about his thoracic stent graft system procedure.
HOUSTON, TX - In an effort to evaluate the best treatment options for patients with life-threatening aneurysms involving the thoracic (chest) aorta, the body's largest artery, the Michael E. DeBakey VA Medical Center (MEDVAMC) in conjunction with Baylor College of Medicine and the Methodist Hospital are participating in an FDA-approved clinical trial of a thoracic stent graft system. This trial is limited to 35 sites across the country and the MEDVAMC is the only participating VA facility.
An aneurysm is a ballooning of an artery resulting from a weakening or stretching of the vessel wall. The aorta, as the largest blood vessel in the body, carries blood from the heart to be distributed by branch arteries through the body. When an aneurysm occurs in the thoracic aorta, the results can be fatal because of the risk of rupture.
It is estimated there are more than 21,000 patients diagnosed with thoracic aortic aneurysms every year in the U.S. Many of these patients also have other serious conditions such as heart disease, lung problems, high blood pressure, and diabetes, making it difficult - if not impossible - for them to survive an open chest operation, the traditional treatment of choice.
In an open chest operation, the thoracic aortic aneurysm is repaired by cutting open the aneurysm and replacing it with a synthetic vessel tube. This operation can be risky and can lead to death in many frail and elderly patients. For those patients considered ineligible for open surgical repair, conservative medical management or "watchful waiting" is often used as a treatment option and can lead to increased mortality and morbidity in many elderly patients.
The MEDVAMC is now offering a new treatment option where a catheter is placed in the groin artery leading to the aorta. The doctors use the catheter to place a small device called a stent graft inside the thoracic aorta. The stent graft is expanded and fixed in place to repair the aneurysm. This new procedure does not require an open chest incision so most patients can return home in as little as one or two days following the procedure.
"The Michael E. DeBakey VA Medical Center, here in Houston, is the only VA hospital in the country that is participating in this study. This is an extremely important trial because it will allow us to explore the safety and effectiveness of a stent graft device that could potentially save thousands of patients with thoracic aortic aneurysms who die each year because of rupture," said Peter Lin, M.D., chief of the MEDVAMC Vascular Surgery Section and one of the lead investigators for the Houston trial.
Lin and two other MEDVAMC vascular physicians, Alan Lumsden, M.D. and Ruth Bush, M.D. have been involved in similar thoracic stent graft trials since 1998. They have collectively performed more than 60 thoracic stent graft procedures. "The advantage of the stent graft technology is that it will allow us to treat thoracic aneurysm patients who previously would have been unable to undergo the open chest operation. The results of our patients who were treated with thoracic stent grafts have been excellent," said Lumsden.
"Patients who undergo the thoracic stent graft procedure can typically resume their normal activities within a week following the operation. This is in contrast to the two to three months of recovery if they undergo the conventional open chest operation. With patients who have underlying lung disease and do not tolerate general anesthesia, this procedure can be performed under local anesthesia," said Bush.
Designated as a Cardiothoracic Center of Excellence, the MEDVAMC is widely known for its unsurpassed record in caring for veterans with cardiothoracic diseases. Ernesto Soltero, M.D. and Joseph Huh, M.D., MEDVAMC cardiac surgery physicians, have received national recognition for their expertise and excellent outcomes in patients undergoing heart and chest operations at the MEDVAMC. Working in conjunction with these cardiac surgery physicians, Lin, Bush, and Lumsden are eager to combine their expertise to offer this minimally invasive therapy to veterans with thoracic aneurysms in this clinical trial. If you or someone you know would like more information about thoracic aortic aneurysms or this trial, please call (713) 794-7895.
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Point of Contact: VHAHOU Public Affairs04/21/04 08:25