Surgeon Weighs Pros,
Cons of New Aneurysm Surgery
Gary R. Seabrook, MD
Medical College of Wisconsin Vascular Surgeon
Named one of the "Best Doctors in America®" 2004 by Best Doctors, Inc.
"There are two techniques for aneurysm repair, and a new method is the hot topic right now."
Gary Seabrook, MD, is a member of the Froedtert & Medical College Vascular Program. He talks about a cutting-edge option for treating abdominal aortic aneurysms.
Q. What exactly is an abdominal aortic aneurysm?
An aneurysm is an abnormal enlargement of a blood vessel. The aorta is the main blood vessel that runs from your heart to the upper part of your chest and down into the abdomen. Aortas can enlarge dramatically, and if they get too large, they will burst.
Q. Could you describe the surgery?
There are two techniques for aneurysm repair, and a new method is the hot topic right now. The traditional approach is to make a fairly long incision in the abdomen, open up the aorta and then sew a graft [a synthetic tube] to the artery.
Q. What is the alternative surgery?
The alternative is called an endovascular repair. First, we collect numerous measurements of the artery from a three dimensional CT scan and then design a graft from several components, which are then wrapped up in little straw-like canisters.
Instead of making a big incision in the abdomen, we make two small incisions in the upper part of the legs. We feed the canister up into the aorta, get it in position in the aneurysm and pull a "rip cord." The canister opens up and the graft attaches to the aortic wall — it has little barbs that hold it in place. Basically, you seal off the aneurysm.
The upside — most people are virtually back to normal in a few days. The downside is the risk of the aorta changing after you've put the graft in place. You have to come back every so often and let us make sure that nothing has shifted.
Because we don't have 10 or 20 year follow-up data, the statistics say that a traditional aneurysm repair is still the best way to treat the problem long-term.
Author: Gary R. Seabrook, MD
Source: Every Day
Date: May-August 2004