New Minimally-Invasive Surgery Treats Abdominal Aortic Aneurysms

Custom-made stent spares patients the impact, recovery time of open surgery

CHICAGO, Jan. 23, 2014 /PRNewswire-USNewswire/ -- Twelve years ago, a routine ultrasound found what Chicago resident Lou Casa could not feel — a tiny, pulsating, potentially fatal bulge in the part of the aorta passing through his stomach region called an abdominal aortic aneurysm (AAA). AAA is the most common type of aortic aneurysm and most often occurs in people over 65 years of age. While they often exist without symptoms and may go undetected, there is a risk of rupture that can lead to death within minutes.

Casa was vigilant about follow-up care, checking in annually with doctors to see if the AAA was changing size or shape. In May 2013, Northwestern Medicine® doctors told him it was time for surgery and suggested he have a new, minimally invasive procedure using a device that would be custom-made for him.

"When we put a graft inside the aneurysm it creates a new lining for the aorta, the main artery carrying blood from the heart to the rest of the body," said Andrew Hoel, MD, a vascular surgeon who performed Casa's surgery. "The grafts take pressure off the aneurysms so they are not at risk for rupturing."

Traditional open surgery to repair AAA requires an abdominal incision and stopping the flow of blood through the aorta during surgery. Patients typically spend at least one night in intensive care and up to nine days in the hospital recovering.

Northwestern Medicine surgeons are now using a new device called the Zenith Fenestrated AAA Endovascular Graft, which is custom made for each patient. With the new endovascular procedure, the entire repair is performed through the femoral arteries, which are located at the level of each hip where the abdomen and the thigh meet. With the surgeon using X-ray for placement, the grafts are inserted through the arteries into the patient's blood stream, moving to the blood vessels where the aneurysm is located. The aneurysm is sealed off, allowing blood to flow freely through the grafts that remain in the body. There are no incisions on the abdomen and no stitches.

"This device is particularly useful for treating patients, like Mr. Casa, with an aneurysm next to the renal arteries," said Hoel, who is also an assistant professor of vascular surgery at Northwestern University Feinberg School of Medicine. "In the past, patients with an aneurysm near their kidneys would have required an open surgical repair. With this device, we can now treat these aneurysms with a minimally invasive approach. For patients, this can mean less time in the hospital and a much shorter total recovery time."

Casa, 79, a retired businessman, long-time advocate of children with special needs and active grandfather of five who has been married for 55 years, said he was back to his get-up-and-go lifestyle days after the surgery.

"I'm feeling great," Casa said. "I felt no pain before, during or after. That's why they call it a silent killer. When that thing bursts you don't have much time before you meet your creator."

Northwestern has been at the forefront of the treatment of aortic aneurysms, with surgeons here performing the first endovascular aneurysm repair in Chicago in 1993. In the 20 years since, endovascular aneurysm repair has become the most common treatment for aortic aneurysms, accounting for nearly 80 percent of aneurysm repairs in the United States.

The Center for Vascular Disease is part of the Bluhm Cardiovascular Institute, ranked first in Chicago and Illinois and twelfth in the country on the U.S. News & World Report 2013-14 Best Hospitals specialty ranking for cardiology and heart surgery.

For more information about abdominal aortic aneurysms and the Zenith Fenestrated AAA Endovascular Grafts, or to schedule an appointment, call (312) NMHEART or request a first time appointment online.

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Northwestern Medicine^® is the collaboration between Northwestern Memorial HealthCare and Northwestern University Feinberg School of Medicine around a strategic vision to transform the future of healthcare.  It encompasses the research, teaching and patient care activities of the academic medical center. Sharing a commitment to superior quality, academic excellence an d patient safety, the organizations within Northwestern Medicine comprise more than 9,000 clinical and administrative staff, 3,100 medical and science faculty and 700 students. The entities involved in Northwestern Medicine remain separate organizations. Northwestern Medicine is a trademark of Northwestern Memorial HealthCare and is used by Northwestern University.

About Northwestern Memorial Hospital
Northwestern Memorial is one of the country's premier academic medical center hospitals and is the primary teaching hospital of the Northwestern University Feinberg School of Medicine. Along with its Prentice Women's Hospital and Stone Institute of Psychiatry, the hospital has 1,705 affiliated physicians and 6,769 employees.  Northwestern Memorial is recognized for providing exemplary patient care and state-of-the art advancements in the areas of cardiovascular care; women's health; oncology; neurology and neurosurgery; solid organ and soft tissue transplants and orthopaedics.

Northwestern Memorial has nursing Magnet Status, the nation's highest recognition for patient care and nursing excellence. Northwestern Memorial ranks 6^th in the nation in the U.S. News & World Report 2013-14 Honor Roll of America's Best Hospitals. The hospital is recognized in 14 of 16 clinical specialties rated by U.S. News and is No. 1 in Illinois and Chicago in U.S. News' 2013-14 state and metro rankings, respectively. For 14 years running, Northwestern Memorial has been rated among the "100 Best Companies for Working Mothers" guide by Working Mother magazine. The hospital is a recipient of the prestigious National Quality Health Care Award and has been chosen by Chicagoans as the Consumer Choice according to the National Research Corporation's annual survey for 15 consecutive years. 

SOURCE Northwestern Medicine