Less Invasive Treatment for Aneurysms Now Available

December 9, 1999

If Robert Lambeth of Winston-Salem had to develop a life-threatening aneurysm in his abdomen, the timing couldn''t have been better.

Last week, Lambeth, 69, was the first person in the Triad to benefit from a newly approved treatment that helped him avoid major surgery and significantly shortened his hospital stay and recovery time.

Rather than having abdominal surgery to repair the weak area in his aorta, the body''s major artery, doctors at Wake Forest University Baptist Medical Center inserted an expandable cylinder-shaped device into Lambeth''s aorta to seal the damaged vessel and provide a new path for blood flow. Lambeth felt well enough to leave the hospital within 24 hours.

Studies have shown that the procedure - which requires only two small incisions - is just as effective as major abdominal surgery at preventing the vessel from rupturing and causing death.

The Medical Center is the first in the region to offer the new treatment, which was approved by the Food and Drug Administration in September. The device, called the Medtronic AneuRx Stent Graft System, is placed in an artery in the thigh and is then guided through the arteries to the aorta.

"This is the first new treatment for abdominal aortic aneurysms in 40 years," said John Ligush Jr., M.D., assistant professor of surgery, who performed the procedure with Kim Hansen, M.D., professor of surgery. "For most patients, it will cut their hospital stay in half and allow them to return to work after a week, compared to six weeks with the conventional surgery."

The hospital stay with the new procedure is one to two days in most cases, compared with a week or more for the conventional procedure.

The stent graft is a mesh-like cylinder that fits inside the artery. Made of woven polyester supported by a frame of nickel titanium, the device is designed to expand to fit and seal aortas of varying size. Conventional treatment for the condition is surgery to open the abdomen and sew another vessel to the aorta to "bypass" the aneurysm.

Ligush said the new treatment may be especially beneficial to older patients who cannot tolerate surgery. The condition is most common in people over age 55. Nearly 10 percent of men over age 65 are likely to have some form of aneurysm.

Abdominal aortic aneurysm (AAA), often referred to as triple A, is the 13th leading cause of death in the United States. The condition is a bulge in the aortic artery that is almost always caused by arteriosclerosis, the build-up of plaque on the inside of the artery that damages and weakens it. If the condition is not treated early enough, the weakened area can rupture and cause death.

It is estimated that 1.5 million Americans have AAA, but because many people have no symptoms, only about 200,000 cases are diagnosed each year. Warning signs of AAA can include abdominal or back pain. At this point, however, the artery walls have become severely dilated and the aneurysm has grown to a dangerous size. If an aneurysm is not repaired and ruptures, the survival rate is only 25 percent.

In most cases, aneurysms grow gradually each year. It can take 10 to 15 years for an aneurysm to reach the size that repair is needed.

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Media Contacts: Karen Richardson, (336) 716-4453 or Jim Steele, (336) 716-3487.

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