Repairing an Aneurysm Triple Threat

From an article by Tammy White with
Dr. William Jackson
McLeod Vascular Associates

“I operate a full-time yard service company six days a week. Three to four weeks after my surgery, I started riding my lawn mower again.”  — Steve McCracken

One aneurysm – a bulging blood vessel – can be life-threatening if it bursts. Yet, what if you went to the doctor for back pain and discovered you had three potentially deadly aneurysms. Steve McCracken’s journey started with a visit to Dr. Lisa Lanning at the McLeod Family Medicine Center. She referred McCracken to McLeod Vascular Surgeon Dr. William Jackson, who confirmed the existence of three aneurysms, one very close to the arteries that feed blood from the heart to the kidneys.

Each of McCracken’s aneurysms required a unique approach for repair.

For the first aneurysm, Dr. Jackson planned a fenestrated endovascular aortic repair (FEVAR), a form of endovascular surgery using a custom-designed graf that would take four to six weeks to arrive.

When an aneurysm is located near an organ, such as a kidney, there often is not much room for the vascular surgeon to attach the graft. FEVAR makes it possible to treat the aortic aneurysm that cannot be treated by the traditional treatment method. A custom graft was made using a computed tomography (CT) scan of Steve’s aorta. The graft is designed with holes (fenestrations) that correspond to the unique positioning of the arteries in the body that branch off from the aorta to the kidneys, small bowel and liver.

Once Dr. Jackson implanted the fenestrated endograft inside the aneurysm, blood flowed through the diseased area without putting pressure on the aneurysm.

The second and third aneurysms were in the iliac arteries, which carry  the primary blood supply to the lower limbs. Without proper blood flow to the limbs, a person can lose use of their legs.

Similar to McCracken’s first aneurysm, the second aneurysm in the iliac artery also did not have adequate room to allow the vascular surgeon to easily attach a graft. Dr. Jackson used an Iliac Branch Endoprosthesis, a graft fully designed to meet all the challenges of repair in this difficult location.

The third aneurysm was repaired with endovascular coiling, a procedure to block blood flow into an aneurysm. Dr. Jackson packed the coils tightly inside the aneurysm to prevent growth and  rupture.

“Technology at McLeod allowed us to perform this large, complex repair through a two-inch incision in the groin area. If performed as an open procedure, Steve’s recovery time would have been much longer and more difficult for him,” said Dr. Jackson.

For more details on this story and procedure, click here and check page 28.