Published on February 05, 2018

Concord Hospital Offers New, Advanced Endovascular Procedure for Patients with Aortoiliac Aneurysm

Patients with large aneurysms in arteries that feed the lower body now have a new treatment option at Concord Hospital that removes the threat of an artery rupturing, without sacrificing normal blood circulation.

The key is a new device, a specialized stent graft that provides a safe path for blood flow when inserted into an artery weakened by an aneurysm. Aneurysms are thin spots in an artery wall that bulge like a balloon and can rupture.

The new stent graft is used to treat aneurysms in the aorta and iliac arteries. Blood leaves the heart in the aorta and flows into other smaller arteries throughout the body. The aorta branches into two iliac arteries near the belly button that lead down toward the left and right sides of the lower body. Each iliac artery then splits into two smaller iliac arteries to feed the legs and organs in the pelvis. Imagine a tree trunk, spreading downward to multiple roots.

The procedure is called endovascular repair of the iliac artery or aortoiliac aneurysms – repairing weakened iliac arteries or the section of the aorta that feeds them by inserting a tube-like stent graft inside the artery to relieve pressure on the ballooning artery wall.

As recently as a year ago, treatment for those specific aneurysms would involve either open surgery – a major procedure in which the aneurysm is bypassed – or inserting a stent that would ease pressure on the aneurysm in one iliac artery, but block the path for blood that normally would branch into another.

The new device, called the Gore Excluder Iliac Branch Endoprosthesis, includes multiple branches of its own, so while one segment strengthens a weakened iliac artery, a second extends into the healthy iliac artery. Thus, the procedure repairs the aneurysm and maintains normal blood flow to the healthy artery, instead of blocking it and causing potential serious complications.

“This is critically important for patients who are not able to withstand open surgery, or who do not have good circulation in the iliac arteries on their other side,” said Dr. Sebastiano DiDato of Concord Hospital Medical Group Concord Surgical Associates who performed Concord Hospital’s first procedure with the new device in October 2017.

The stent grafts are inserted through tiny incisions in the patient’s groin, and the patients typically go home the next day. Patients not eligible for stent grafts because of the shape and angles of arteries typically undergo open surgery, which involves more risk for complications and a week-long hospital stay, or the traditional stent procedure, which blocks a healthy artery.

“We now offer advanced endovascular aortoiliac surgery here at Concord Hospital. Patients no longer have to travel outside of their local community for advanced treatment of their aneurysms,” said Dr. DiDato.

Treatment is essential because ruptured aneurysms usually are fatal, Dr. DiDato said, and there are typically no preceding symptoms. He said screening is important for those most at risk for aortoiliac aneurysms: people with a family history of such aneurysms and men older than 60 years of age who have been smokers.