Aortic Stent Graft: A Minimally Invasive Procedure for Abdominal Aortic Aneurysm

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“After Dr. Dicker showed me the before and after pictures, I was shocked. I probably wouldn’t have made it through the year.” –Mark Fillmore, Prescott Valley

An aortic aneurysm is a weakened area in the body’s largest artery, the aorta, which carries blood from the heart to the rest of the body. As blood flows through this blood vessel, the weakened area bulges like a balloon and can burst if it grows too large.

An abdominal aortic aneurysm (AAA) is an aneurysm that forms in the abdomen behind the navel. When felt through the skin, it can feel like a pulse in the belly. If it bursts, a person can experience signs of shock, nausea or paleness and has an 80-90 percent chance of immediate death due to significant blood loss in a very short amount of time.

Local Interventional Cardiologist, James D’Antonio, M.D., said, “AAA’s are most often asymptomatic and are found through a physical examination or screening imaging. Abrupt onset of abdominal or back pain of a tearing quality suggests an unstable aortic syndrome, which might include a pending AAA rupture and should prompt immediate medical attention.”

Prescott Valley resident, Mark Fillmore, had no idea he had this kind of aneurysm. He was experiencing kidney pain and his nephrologist sent him to have an ultrasound. Although his kidneys were determined to be healthy, the ultrasound technologist noticed the very large abdominal aneurysm.

When AAA’s grow to be about 5 centimeters they are considered large enough to treat in order to prevent them from rupturing. Mr. Fillmore’s measured at 6.3 centimeters.  He was referred to Dr. D’Antonio for follow up.

Dr. D’Antonio said, “Often, men over the age of fifty, especially those who have smoked, have peripheral arterial disease, or who have diabetes, are at higher risk of developing AAA.”

It is recommended that men over the age of 65 – especially those who have smoked – have an ultrasound of the abdominal aorta to rule out an aneurysm.

Family history is also important to consider. Dr. D’Antonio added, “A first degree relative with AAA is an important risk factor.”

Dr. D’Antonio then referred Mr. Fillmore to interventional radiologist Matthew Dicker, M.D., who discussed with him the importance of having an interventional procedure such as an aortic stent graft placed instead of surgery.

Dr. Dicker said, “Treating AAA percutaneously, or through the skin, via a tiny, 3 mm incision, is far superior to the older surgical method where a large incision was made in the abdomen. This allows for much faster healing and recovery time with only a fraction of the pain.”

Dr. D’Antonio added, “Currently, the vast majority of AAA’s are managed with stent grafts. Open surgical repair is reserved for patients who have anatomy unsuitable for stent graft placement.”

“Full recovery from surgery can take several months. The hospital stay with this minimally invasive approach is usually only overnight. The complications such as bleeding, infection, bowel and other organ injury are dramatically reduced,” added Dr. Dicker.

Drs. Dicker and D’Antonio worked together to place Mr. Fillmore’s stent graft. They used YRMC’s new, state-of-the-art hybrid operating room on the West Campus in Prescott.

Dr. D’Antonio said, “This collaboration between Radiology and Cardiology is a perfect example of how a team approach improves patient care for our community.”

”If I would have dropped one of my motorcycles and strained to pick it up, it probably would have been it for me,” said Mr. Fillmore.

Dr. Dicker added, “Ask your doctor about screening for AAA early to detect and treat this silent killer.”

If you think you might be at risk for developing AAA, please contact your primary care physician, your cardiologist or contact Vascular and Interventional Specialists of Prescott at (928) 771-8477 for diagnosis and treatment options.

 

Related: Defining Interventional Radiology: Meet Your Local IR Doctors

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