Continuing its prominent regional and national role as a top-tier center for the treatment of arterial and venous disease, the division of vascular surgery and endovascular therapy of the Emory University School of Medicine now provides implantation of the FDA-approved Zenith® Fenestrated Endovascular Graft. Emory vascular surgeons Yazan Duwayri, MD, and Ravi Veeraswamy, MD, recently performed Georgia’s first implantation of the stent graft, which has been approved as a minimally invasive treatment option for patients with abdominal aortic aneurysms (AAA) that possess an aneurysm anatomy that is incompatible with currently available devices.
“In recent years, endovascular techniques have greatly improved the safety of surgical treatment of AAA, but there are high risk patients whose aneurysms are too close to the arteries that feed the kidneys to qualify for these methods,” says Dr. Veeraswamy. “If placed, the endovascular graft itself would block blood flow. And unfortunately, traditional, open techniques of repair have significantly high morbidity and mortality rates.”
Designed as an endovascular alternative for such patients, the fenestrated system is associated with faster recovery and decreased risk of complications. The most unique factor of the graft—essentially a tube of fabric and metal that functions as a sleeve inside the aorta that excludes the aneurysm from blood flow—is that it can be customized to accommodate the anatomical specifications of each individual patient. “We use specialized software to design the fenestrations or scallops of the Zenith device so that they line up with the patient’s renal and mesenteric arteries,” says Dr. Duwayri. “Through these holes, we can place additional stents into the branch arteries to repair the aneurysm.”
The graft is inserted through small punctures in the groin and femoral arteries and guided into place using x-ray images. Wires, catheters, and stents can be placed inside the artery without the external aorta ever being touched.
By offering this new, FDA-approved technology and other devices in the clinical trial phase, Emory vascular surgeons are advancing the delivery of care to patients with these complex aneurysms.
About Ravi Veeraswamy, MD
Dr. Veeraswamy specializes in surgery and vascular surgery, and has been practicing with Emory since 2006. Some of his areas of clinical interest include aortic aneurysm, carotid endarterectomy, peripheral arterial and vascular disease, and vascular surgery. Recently, Dr. Veeraswamy has published articles in the Washington University Manual of Surgery, Vascular and Endovascular Challenges, and the Annals of Vascular Surgery.
About Yazan Duwayri, MD
Dr. Duwayri specializes in endoluminal and open vascular surgery. His areas of clinical interest include treatment of carotid stenosis, abdominal and thoracic aortic aneurysms, aortoiliac occlusive disease, renal arterial stenosis, thoracic outlet syndrome, dialysis access, peripheral arterial disease, and venous disease.