Posts Tagged ‘aortic aneurysm’

New Treatments for High Risk Complex Abdominal Aortic Aneurysms Patients

Aortic Aneurysm TreatmentIn recent years, endovascular techniques have greatly improved the safety of surgical treatment for patients with abdominal aortic aneurysms (AAAs) who had concomitant health conditions that affect cardio-pulmonary and renal function. Because many patients with AAAs do not qualify for endo-vascular repair, newer procedures called “fenestrated and branched endografts” were designed as an alternative for these patients. Until recently, fenestrated endografts were not commercially available and surgeons had to modify grafts themselves to repair the AAAs. In November of 2012, Emory vascular surgeons Yazan Duwayri, MD, and Ravi Veeraswamy, MD, performed Georgia’s first implantation of an U.S. Food and Drug Administration (FDA) approved fenestrated graft. The new device can be used to repair aneurysms in patients who are not candidates for other traditional repair options.

Treatment Options for Abdominal Aortic Aneurysms

Emory offers the full range of treatment options for abdominal aortic aneurysms, including open and endovascular repair techniques. For patients who are not candidates for the newer FDA-approved devices, Emory surgeons still offer open surgical and endovascular repair using the chimney and snorkel techniques. We tailor AAA treatment, selecting the treatment option that is most appropriate for each patient. Learn more about our

There are many benefits to fenestrated endovascular repair including:

  • Shorter days in ICU
  • Less blood loss
  • Fewer mortalities
  • Fewer complications post surgery
  • Shorter average number of days to resume normal diet
  • Fewer days spent in the hospital

Fenestrated Graft Procedure Video



Learn more about fenestrated and branched endografts >>


Dr. Ravi VeeraswamyAbout Ravi Veeraswamy, MD

Dr. Veeraswamy specializes in vascular surgery, and has been practicing with Emory since 2006. Some of his areas of clinical interest include aortic aneurysm repair, carotid endarterectomy and stenting, 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.

 

Yazan Duwayri, M.D.About Yazan Duwayri, MD

Dr. Duwayri specializes in endoluminal and endovascular 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. He has published articles in several journals including the Journal of Vascular Surgery and Annals of Vascular Surgery, in addition to several textbook chapters.

Related Resources

Back to Life After an Aortic Aneurysm – Part II

As part of our commitment to providing the best patient-centered care possible, our team of physicians, nurses, specialists, and staff make advancing the medical possibilities a priority each and every day. There are only so many factors we can control, however, and sometimes, it is perfect timing coupled with the efforts of our team that make treatment for our patients that much more successful.

Warren "Allen" Owens

Take Allen Owens, for example. He may be someone you’re familiar with if you frequent our heart & vascular blog. We introduced you to him in a post a few weeks back detailing his remarkable story. Prior to arriving at Emory, Allen experienced 8 heart attacks, 21 congestive heart failures, had 13 stents placed, had 5 bypass surgeries (4 of them failed) and had taken 4 life flights (emergency helicopter rides to the hospital). On each life flight he was not expected to make it to the hospital because of his critical status.

It may sound like Allen faced a run of unfortunate health bad luck. After all, he did what he could to prevent a decline in his health. He’s not a smoker or a drinker, and considered himself to be a relatively healthy adult.

Perhaps surprisingly, it was when his local doctors were out of answers that Allen’s life (and luck) changed for the better. He was referred to Emory and last summer, received another diagnosis to add to his plate – Allen’s abdominal aorta was weakening and he had developed an aortic aneurysm that was ballooning and could burst at any time. You may be wondering, what’s lucky about that? The majority of aortic aneurysms are found after they burst, and fortunately, doctors caught Allen’s prior to this happening.

What’s more, Allen’s health wasn’t strong enough to undergo another heart surgery to repair the problem. Once again, Allen’s luck was changing for the better. At about the same time that Allen was diagnosed with his aortic aneurysm, Dr. Joseph Ricotta, a vascular surgeon, had just transitioned his career at the Mayo Clinic to working at Emory Healthcare. At the Mayo Clinic, Dr. Ricotta had perfected a new procedure to treat aortic aneurysms, an alternative aortic aneurysm treatment he brought with him to Emory– the use of fenestrated and branched aortic endografts, a procedure Dr. Ricotta has performed approximately 120 times thus far.

Six months after performing this revolutionary procedure for Allen, Dr. Ricotta told Fox 5 News the graft is working perfectly, “The aneurysm’s shrinking actually. There’s no evidence of leak and all the branches to his intestines and kidneys are open and look very good.”

The procedure and Dr. Ricotta’s presence in Atlanta have hopefully put an end to this Cherokee County native’s run of bad luck. It’s Allen’s hope now, that with his condition under control, he will be able to qualify for a heart transplant. “This will be eight years in April, that I’m not supposed to have,” Allen told Fox 5 News.

You can learn more about the fenestrated and branched aortic endograft procedure for aortic aneurysms, and learn more about the story of Allen Owens by watching this video from Fox 5 News below:

“Back to Life” After an Aortic Aneurysm

September 2, 2010 was a memorable day for Emory patient Warren (Allen) Owens when he realized years of heart trauma were behind him.

Previously, Mr. Owens had experienced 8 heart attacks, had been diagnosed 21 times with congestive heart failure, had 13 stents placed, had 5 bypass surgeries ( (4 of them failed) and had taken 4 life flights (emergency helicopter rides to the hospital). On each life flight he was not expected to make it to the hospital because of his critical status.

Mr. Owens was referred to Emory after physicians at his local hospital were no longer able to help him with his life-threatening condition, an 8-cm aortic aneurysm that was at risk of rupturing. At Emory, patients with complex aortic aneurysms like Mr. Owens now have an option they did not have before – the fenestrated and branched endograft procedure that we discussed in a previous blog post. Now over a year later Mr. Owens is able to perform the daily tasks that he could not do before the surgery. He credits Emory physicians with “bringing him back to life.”

“I can’t put it into words how thankful I am that he was able to do what he did and bring me back to a semblance of my former life.” – Warren Owens

Listen to Mr. Owens touching story by watching the video below.

About Joseph J. Ricotta II, MD:
Dr. Ricotta specializes in vascular and endovascular surgery, and came to Emory from the Mayo Clinic in August 2010. His areas of clinical interest include fenestrated and branched endografts to treat aortic aneurysms, thoracoabdominal aortic aneurysms, peripheral aneurysms, PAD, carotid endarterectomy and carotid stenting, mesenteric and renal artery disease, and venous diseases. He has authored several journal articles and book chapters on the topic of fenestrated and branched endografts, and holds organizational leadership memberships at the American Medical Association, the American College of Surgeons, the Society for Clinical Vascular Surgery and the Society for Vascular Surgery.

The Emerging Role of Fenestrated & Branched Aortic Endografts in the Treatment of Complex Aortic Aneurysms

Dr. RicottaAs Dr. Kasirajan mentioned in the last blog about aortic aneurysms, this condition can cause serious medical issues or even death. For patients with large complex aneurysms, there is a new procedure that we are performing at the Emory Heart & Vascular Center called a fenestrated and branched stent graft. This procedure is a viable option for patients who may have once been considered inoperable. These grafts are now used in select high-risk patients with complex aneurysms that are located throughout the entire length of the aorta.

In addition to being a safe and effective option for high-risk patients, fenestrated and branched endograft implantation provides patients with a number of benefits including:

• No incisions
• Shorter hospital stays (one or two days vs. 10 to 14 days for open surgical repair)
• Quicker recovery

Unfortunately, these devices are not yet commercially available in the United States. In countries where they are available, the grafts must be customized for each patient, a process that can take up to 12 weeks. During this time patients are at risk for a rupture in their aneurysm. As an alternative since 2007, several vascular surgeons in the United States have been custom-making fenestrated and branched stent grafts using available components.

Emory currently is one of only a few institutions in this country and the only one in the Southeast that offers these investigational procedures.

Fenestrated and branched endografts appear destined to play a key role in the management of complex aortic aneurysms. Research results have shown that these devices are both safe and effective in treating carefully selected patients, with low incidence of complications. Although additional research is needed to substantiate these results, Emory is poised to participate as a primary site in proposed clinical trials of these innovative devices.

You can learn more about Emory’s fenestrated and branched aortic stent graft program at www.emoryhealthcare.org/vascular

Do you have questions about fenestrated and branched aortic endografts? If so, feel free to ask away in the comments section.

About  Joseph J. Ricotta, MD:

Dr. Ricotta specializes in vascular and endovascular surgery, and came to Emory from the Mayo Clinic in August 2010.  His areas of clinical interest include fenestrated and branched endografts to treat aortic aneurysms, thoracoabdominal aortic aneurysms, peripheral aneurysms, PAD, carotid endarterectomy and carotid stenting, mesenteric and renal artery disease, and venous diseases.  He has authored several journal articles and book chapters on the topic of fenestrated and branched endografts, and holds organizational leadership memberships at the American Medical Association, the American College of Surgeons, the Society for Clinical Vascular Surgery and the Society for Vascular Surgery.

Are You at Risk for an Aortic Aneurysm?

Emory Heart & Vascular

An Aortic aneurysm is a serious vascular condition and a leading cause of sudden death in men over 60. Therefore, it is important that we discuss what aortic aneurysms are, possible symptoms and how to treat them.

What are aortic aneurysms?

Aneurysms are abnormal bulges (ballooning) in the wall of an artery. Many aneurysms occur in the aorta (the main artery that carries blood from the heart to the rest of the body). Since the section with the aneurysm is overstretched, it can burst. If the aorta bursts, it usually causes serious bleeding. If not treated very quickly a burst aorta can quickly lead to death.

There are two main types of aortic aneurysms:

  1. Thoracic aortic aneurysms – these aneurysms occur in the part of the aorta that runs through the chest.
  2. Abdominal aortic aneurysms – these aneurysms occur in the part of the aorta that runs through the abdomen.

What are causes/symptoms of aortic aneurysm?

Some medical problems like high blood pressure or hardening of the arteries weaken the artery walls and can result in a weak aortic wall that will bulge.
Unfortunately aortic aneurysms do not usually cause symptoms so we recommend screening tests for aneurysms for men who are in the following categories:

  • 65 to 75 and have smoked in his lifetime or
  • 60 years old and have a first-degree relative (father or brother) who has had an aneurysm.

Some people say they have belly, chest, or back discomfort that may come and go or stay constant. If not diagnosed and treated the aortic aneurysm can lead to other problems such as blood clots that lead to stroke or blood clots that form an aortic aneurysm in the belly or legs.

If you are an older male with high blood pressure, a family history of abdominal aortic aneurysms in first degree relatives that you are at risk for an aortic aneurysm and have been a smoker or alcohol drinker you could be at risk.

If you think you have an aneurysm, we recommend you call your physician and schedule a screening test. Your physician will likely perform an ultrasound, a CT scan, or an MRI to find out where it is and how big it is.

About Karthik Kasirajan, MD:
Dr. Kasirajan specializes in surgery and vascular surgery, and has been practicing at Emory since 2003. Several of his areas of interest include peripheral arterial disease, endovascular surgery, abdominal and aortic aneurysm, vascular surgery, thrombotic disease, and stroke. Dr. Kasirajan holds many organizational leadership memberships, including the European Society for Vascular Surgery, International College of Surgeons, and the Peripheral Vascular Surgical Society, and is widely published in publications such as the Journal of Endovascular Therapy and the Journal of Vascular Surgery.