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New Surgical Procedure For Abdominal Aorta Aneurysms | |
By DR. THOMAS S. RILES A new surgical technique promises to make repair of a condition that causes potentially life-threatening weakness of the abdomen's main artery safer and less painful. More than 40,000 new cases of abdominal aortic aneurysm, as the condition is called, are diagnosed each year. Most are in persons 60 and older and most are in men, by a 5-1 ratio. Although, many patients have a genetic predisposition for aneurysms, other risk factors include high blood pressure, atherosclerosis and cigarette smoking. The aneurysm causes no symptoms in most cases. The reason for repairing aneurysms is to prevent rupture, a catastrophic event associated with major internal bleeding. Rupture of an aneurysm is fatal in perhaps 75 percent of cases, even if the patient is able to survive long enough to undergo emergency surgery. Aneurysm rupture is the 13th leading cause of death in the United States. Aneurysms usually are detected by X-rays or palpation of the abdomen. If they are small, the risk of rupture is negligible and surgical repair is not indicated. Surgery is generally done when an aneurysm reaches a diameter of 5 centimeters - 2 inches. In the operation, the weakened area of the aorta, the main artery delivering blood to the abdomen and legs, is replaced by a polyester graft. It is a three-hour operation that typically requires a hospital stay of eight to 10 days and a three-week recuperation period at home. The new procedure, now undergoing trials in major medical centers in the United States, can allow patients to go home after two days in the hospital and to resume normal activities in not much more than a week. Instead of the long abdominal incision done in the current procedure, the new technique requires only a small opening in an artery in the groin. The physician then inserts a small capsule containing the polyester graft, with tiny hooks attached. The graft is attached to the inside of the aorta with a balloon, pressing the hooks to the inside of the arterial wall. Under X-ray guidance, the capsule is threaded up the artery until it reaches the site of the aneurysm. Although more than 200 such grafts have been placed in humans to date, the procedure remains experimental until the Food and Drug Administration has long-term data on the effectiveness of the technique in treating aortic aneurysms. --- Dr. Thomas S. Riles is Professor of Surgery at New York University School of Medicine. Copyright 1996 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed. | |