Physicians at Southeast Georgia Health System are the first in the state
of Georgia to use an innovative new type of stent graft system that may
broaden the group of patients eligible for minimally invasive repair of
abdominal aortic aneurysms. To date, three procedures using the new device
have been performed at the Health System’s Brunswick Campus by Terry
Reynolds, M.D., a board-certified vascular interventional radiologist,
and Stephen Kitchen, M.D., a board-certified general surgeon.
The Ovation™ Abdominal Stent Graft System, made by Trivascular,
received pre-market approval from the U.S. Food and Drug Administration
in October 2012 and was approved for use in Europein August 2010. More
than 1,300 patients have been treated worldwide with the Ovation System.
An aortic abdominal aneurysm is caused by a weakening of the aorta due
to age, disease or other conditions. The aneurysm weakens the wall of
the artery--the largest artery that runs through the body--and a bulge
develops. Left untreated, the aorta can rupture leading to serious internal
bleeding or death.
Aortic abdominal aneurysms can be treated by either open surgical repair
or by a minimally invasive technique called endovascular aortic repair
(EVAR). Open surgical repair involves making an abdominal incision from
below the breast bone to the top of the pubic bone and then sewing the
graft into the artery above and below the aneurysm. EVAR is minimally
invasive compared to open surgical repair.
During the procedure, which is usually performed using general anesthesia,
Dr. Kitchen makes a small incision in the skin of the groin and exposes
the femoral artery. Dr. Reynolds then uses a catheter to guide a stent
graft up the patient’s femoral artery and into position within the
aorta. The stent graft creates a new pathway for the blood to flow reducing
the pressure on the aneurysm and the risk of rupture. Once the stent graft
is in place, Dr. Kitchen closes the artery and skin incision. Dr. Kitchen
is also standing by in the event that the aneurysm ruptures during the
procedure and open surgery is needed immediately.
Although other stent graft devices have been available for years, the
new Ovation Abdominal Stent Graft System offers several advantages. One
is the size which allows the stent graft to be delivered through a smaller
diameter catheter compared to other stent devices. Dr. Kitchen also explains
that its modular components make it a choice for some patients who previously
may not have been candidates for endovascular repair due to the size or
curvature of their aneurysm.
Another benefit is a unique sealing technology that utilizes polymer-filled
rings to maximize the seal. Dr. Reynolds explains, “I think one
of the biggest advantages of this device is the polymer rings that provide
a sealant when filled. During the clinical trials, there were no instances
of leakages and that is very important.”
“Not every stent device is suited for every patient, so we use the
best device for the particular aneurysm, but this probably has the most
flexibility of any stent device available. We will probably be using it
about 90 percent of the time,” Dr. Reynolds says.
Dr. Kitchen adds, “I think that structurally, this will be stronger
than previous devices we’ve used and therefore, less likely to cause
the patient a problem in the future.”
Abdominal Aortic Aneurysm is often called a silent killer because there
are usually no obvious symptoms of the disease. When symptoms are present,
they may include:
- Abdominal pain (that may be constant or come and go)
- Pain in the lower back that may radiate to the buttocks, groin or legs
- The feeling of a "heartbeat" or pulse in the abdomen
If you suspect that you have an abdominal aortic aneurysm, you should
seek medical treatment immediately.