BH Pioneers Aorta

Repair Without Surgery

BRIDGEPORT — Bridgeport Hospital physicians are the first in Fairfield County to use a new type of stent to repair abdominal aortic aneurysms (AAA) without the need for major surgery.

“For patients, the new minimally invasive approach means fewer complications, a shorter hospital stay and faster recovery,” said Dr Marsel Huribal, who was specially trained to perform the new procedure, called endovascular stented graft placement, along with fellow vascular surgeon Dr Chung Shin and Dr Donald Butler, Bridgeport Hospital’s chief of interventional radiology.

Stents are tiny stainless steel frames used to support the walls of blocked or damaged blood vessels once they have been cleared of blockage or the damage repaired. The devices have been used since the mid-1990s at Bridgeport Hospital in coronary arteries following angioplasty procedures to clear blockage. They have a similar use in the arteries of the leg and carotid artery in the neck. In fact, the first carotid artery stent procedure in Connecticut was performed at Bridgeport Hospital in 1997 by a surgical team that included Drs Huribal and Butler.

AAA is a balloon-like enlargement of the aorta that weakens the walls of the artery. Eventually the “balloon” will rupture and, in 80 percent of the cases, be fatal. About 15,000 people die from AAA each year, making it the 13th leading cause of death in the United States. AAA affects 1.5 million people in the United States with approximately 200,000 new cases diagnosed each year. The condition primarily affects men 50 and older. AAA may often go undetected because there are no symptoms. The condition is usually detected by accident during ultrasound tests that can easily be performed in a physician’s office. As public awareness of AAA grows, proactive testing is becoming more common.

Endovascular AAA repair can be done in about three hours while the patient remains awake. It involves making two small incisions in the groin and using a balloon-tipped catheter to guide the stent device through an artery to the site of the aneurysm. Once in place, the balloon is expanded and attaches the stent to the wall of the aorta with a series of small hooks. This allows the stent to remain in place while adapting to changes in the shape and position of the artery.

The average hospital stay for endovascular stent repair is three days and overall recovery time is two to three weeks. There is also less blood loss during the minimally invasive procedure, and the risk of complications, such as stroke, heart attack and respiratory failure, is greatly reduced. In addition, the less risky stent procedure can be performed on patients who may otherwise be unfit for major surgery.

“This type of procedure cannot be done at any hospital,” Dr Huribal said. “It can only be done at a major medical center that has the expertise and support, and where members of the surgical team have received extensive special training.”