Developments continue in treating vascular problems. One of the advances is the ability to repair a bulging aorta tucked dangerously close to valuable organs such as the kidneys. McLeod Vascular Surgeon Dr. William C. Jackson explains the Fenestrated Endovascular Aortic Repair or FEVAR.
Here are highlights from Dr. Jackson’s comments:
An aneurysm is technically defined as a bulging, ballooning or outpouching of an artery that’s greater than 1.5 the diameter of that artery. In layman’s terms, it’s just a ballooning of an artery. The most common location is the aorta below the kidneys.
The easiest way to find an aneurysm is with a physical exam. Any patient I see in the clinic — for any reason, carotid stenosis, peripheral vascular disease — I perform a physical exam. I do an abdominal exam to feel for the presence or absence of what we call a “palpable pulsatile mass.” In other words, I’m feeling for a prominent pulse in the abdominal aorta.
The endovascular approach to treating this problem is novel and it revolutionized the way we treat aneurysms. Previously, patients had a large abdominal incision, were in the hospital for a prolonged period of time and faced a higher risk of complications. With the advent of the endovascular technique, many times these patients go home the next day, their hospital stay is shorter and recovery is quicker.
When we treat the aneurysms with the endovascular approach, we make either two small incisions in the groin to deliver the device or sometimes it can just be done through needle punctures alone.
For the patient who can’t undergo the standard endovascular approach, new advances enable patients to receive a Fenestrated Endovascular Aortic Repair (FEVAR). This helps someone who has an aneurysm close to the kidney arteries. There are certain grafts that we can deploy now to treat those aneurysms and create a seal near those arteries. We perform that new and exciting graft procedure here at McLeod.
There’s really not a way to prevent an aneurysm that we know of currently. There’s a lot of research that’s going into why aneurysms form in the first place, certain risk factor modifications or medications patients can take. Plus, there’s some promising research.
There aren’t specific lifestyle modifications aside from those they’re already doing. Generally controlling blood pressure, cholesterol levels, blood sugars in patients with diabetes, are all important risk factor modifications. They haven’t necessarily been proven to slow the rate of growth of an aneurysm. Smoking has been shown to be a primary risk factor. So, cutting out tobacco use is probably the greatest risk factor modification someone can take.
For smokers, who are 65 years or older, there is a Medicare-funded screening. It’s a one-time screening, for an abdominal ultrasound that looks at the abdominal aorta to identify if there is an aneurysm present.