Published on December 19, 2019

New Procedure Helps Aneurysm Patients 

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

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

The new tubular stent graft, called the Gore Excluder Iliac Branch Endoprosthesis, 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. Near the belly button, the aorta branches into two iliac arteries that carry blood to the left and right sides of the lower body. Each of those arteries then splits into two smaller iliac arteries to feed the legs and organs in the pelvis. 

The new 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 stent graft inside the artery to relieve pressure on the ballooning artery wall.

Until recently, treatment for those specific aneurysms involved either open surgery — a major procedure in which the aneurysm is bypassed — or inserting a stent that eased pressure on the aneurysm in one iliac artery but blocked blood from flowing to the other.

The stent graft 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 potentially serious complications.

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. 

Treatment is essential because ruptured aneurysms usually are fatal and, typically, there are no warning symptoms. 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.

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