Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

More aortic chest aneurysms being treated with less-invasive stents

01.09.2008
Loyola Doctors say Stent Graft Placement Much Easier on Patients than Open Chest Surgery

An estimated 60,000 Americans are walking around with time bombs in their chests called thoracic aortic aneurysms.

At any time, their main chest artery could suddenly burst open, causing massive internal bleeding that is almost always fatal.

It's possible to repair the defect before the artery bursts, but traditional surgery is highly invasive. The operation typically requires an 18-inch incision, a week or two in the hospital and three to six months to recover. There are several major risks, including stroke and paralysis.

At Loyola University Hospital, an increasing number of patients are being treated with a device called a stent graft, which is inserted without opening the chest. Stent graft patients typically go home in a day or two, and recover fully in about two weeks.

At Loyola's Thoracic Aortic Disease Clinic, about 70 percent of patients who undergo surgery for aneurysms in the chest artery are receiving stent grafts rather than open chest surgery. "And as the technology evolves, we will be doing more and more stenting," said Dr. Jeffrey Schwartz, associate professor in the Department of Thoracic and Cardiovascular Surgery at Loyola University Chicago Stritch School of Medicine.

The stent graft used in chest arteries is a polyester tube covered by metal webbing. It is delivered with a catheter (thin tube). The surgeon inserts the catheter in a groin artery, and guides it to the thoracic aorta (chest artery). Once the stent graft is deployed from the catheter, the device expands outward to the walls of the artery. Depending on the patient, the stent graft is roughly 1 inch to 2 inches wide and 4 to 8 inches long, said Dr. Michael Tuchek, who has conducted several clinical trials of aortic stent grafts. Tuchek is a clinical assistant professor in the Department of Thoracic and Cardiovascular Surgery at Stritch.

James Feehan of Bolingbrook, Ill. recently received a stent graft to repair a life-threatening aneurysm in his chest aorta. The aorta is the main artery from the heart. An aneurysm occurs when the walls of the aorta thin and balloon outward. As the bulge grows, there's an increasing risk the aorta could suddenly burst. Feehan had undergone four earlier open-chest surgeries to repair other defects in his aorta. By comparison, the stent graft procedure was "a walk in the park," he said.

Feehan, 78, probably could not have survived another open chest surgery, said Tuchek, who placed the stent graft. Now, thanks to the stent graft, "he can go home and see his grandkids," Tuchek said.

The first-generation thoracic aortic stent grafts were approved in 2005. Feehan recently became one of the first patients in the country to receive the latest-generation stent graft, called Talent. The new device will make it possible for significantly more patients to have stent graft repairs rather than open surgery, Tuchek said.

The difference between the older stent grafts and the new one "is kind of like the difference between a Model T and a Ferrari," Tuchek said.

In a study published recently in the Journal of Vascular Surgery, researchers compared 195 patients who received the new stent graft with 189 patients who underwent traditional open chest surgery. About 84 percent of the open chest surgery patients experienced major complications, compared with only 41 percent in the stent graft group. After 12 months, 11.6 percent of the open chest surgery patients had died of aneurysm-related causes, compared with 3.1 percent in the stent graft group. Tuchek is a co-author of the study, which was funded by the manufacturer of the stent graft.

Loyola's thoracic aortic disease clinic follows more than 1,000 patients. About 80 percent of the patients have aortic aneurysms. Other conditions treated at the clinic include aortic dissection (the inner layer of the aorta's artery wall splits open) and ulcerated plaques (irregular buildup of cholesterol and other deposits in the aortic walls).

Risk factors for aneurysms and other aortic defects include smoking, hardening of the arteries, diabetes, family history, high blood pressure and congenital disorders such as Marfan syndrome. Many people do not realize they have aneurysms until the bulges are detected on CT scans or MRIs.

Because aortic disease is relatively uncommon, many surgeons and cardiologists refer patients to specialty centers such as Loyola. Loyola's aortic clinic treats patients from Illinois, Indiana, Wisconsin, Michigan and Iowa. Patients have come from as far away as Florida and Arizona.

The clinic is a collaborative effort. Schwartz, for example, specializes in open chest surgery, while Tuchek has helped pioneer the use of thoracic aortic stent grafts.

"My vision is that patients with aortic disease receive comprehensive, multi-specialty care for this unique condition," Schwartz said.

Tuchek is a leading enroller in a second multi-center clinical trial of the new stent graft, which is made by Medtronic, and he is a consultant to the company.

Based in the western suburbs of Chicago, Loyola University Health System is a quaternary care system with a 61-acre main medical center campus, the 36-acre Gottlieb Memorial Hospital campus and 22 primary and specialty care facilities in Cook, Will and DuPage counties. The medical center campus is conveniently located in Maywood, 13 miles west of the Chicago Loop and 8 miles east of Oak Brook, Ill. The heart of the medical center campus, Loyola University Hospital, is a 570-licensed bed facility. It houses a Level 1 Trauma Center, a Burn Center and the Ronald McDonald® Children?s Hospital of Loyola University Medical Center. Also on campus are the Cardinal Bernardin Cancer Center, Loyola Outpatient Center, Center for Heart & Vascular Medicine and Loyola Oral Health Center as well as the LUC Stritch School of Medicine, the LUC Marcella Niehoff School of Nursing and the Loyola Center for Health & Fitness. Loyola's Gottlieb campus in Melrose Park includes the 250-bed community hospital, the Gottlieb Health & Fitness Center and the Marjorie G. Weinberg Cancer Care Center.

Jim Ritter | EurekAlert!
Further information:
http://www.lumc.edu

More articles from Medical Engineering:

nachricht New technique makes brain scans better
22.06.2017 | Massachusetts Institute of Technology

nachricht New technology enables effective simultaneous testing for multiple blood-borne pathogens
13.06.2017 | Elsevier

All articles from Medical Engineering >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Can we see monkeys from space? Emerging technologies to map biodiversity

An international team of scientists has proposed a new multi-disciplinary approach in which an array of new technologies will allow us to map biodiversity and the risks that wildlife is facing at the scale of whole landscapes. The findings are published in Nature Ecology and Evolution. This international research is led by the Kunming Institute of Zoology from China, University of East Anglia, University of Leicester and the Leibniz Institute for Zoo and Wildlife Research.

Using a combination of satellite and ground data, the team proposes that it is now possible to map biodiversity with an accuracy that has not been previously...

Im Focus: Climate satellite: Tracking methane with robust laser technology

Heatwaves in the Arctic, longer periods of vegetation in Europe, severe floods in West Africa – starting in 2021, scientists want to explore the emissions of the greenhouse gas methane with the German-French satellite MERLIN. This is made possible by a new robust laser system of the Fraunhofer Institute for Laser Technology ILT in Aachen, which achieves unprecedented measurement accuracy.

Methane is primarily the result of the decomposition of organic matter. The gas has a 25 times greater warming potential than carbon dioxide, but is not as...

Im Focus: How protons move through a fuel cell

Hydrogen is regarded as the energy source of the future: It is produced with solar power and can be used to generate heat and electricity in fuel cells. Empa researchers have now succeeded in decoding the movement of hydrogen ions in crystals – a key step towards more efficient energy conversion in the hydrogen industry of tomorrow.

As charge carriers, electrons and ions play the leading role in electrochemical energy storage devices and converters such as batteries and fuel cells. Proton...

Im Focus: A unique data centre for cosmological simulations

Scientists from the Excellence Cluster Universe at the Ludwig-Maximilians-Universität Munich have establised "Cosmowebportal", a unique data centre for cosmological simulations located at the Leibniz Supercomputing Centre (LRZ) of the Bavarian Academy of Sciences. The complete results of a series of large hydrodynamical cosmological simulations are available, with data volumes typically exceeding several hundred terabytes. Scientists worldwide can interactively explore these complex simulations via a web interface and directly access the results.

With current telescopes, scientists can observe our Universe’s galaxies and galaxy clusters and their distribution along an invisible cosmic web. From the...

Im Focus: Scientists develop molecular thermometer for contactless measurement using infrared light

Temperature measurements possible even on the smallest scale / Molecular ruby for use in material sciences, biology, and medicine

Chemists at Johannes Gutenberg University Mainz (JGU) in cooperation with researchers of the German Federal Institute for Materials Research and Testing (BAM)...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Plants are networkers

19.06.2017 | Event News

Digital Survival Training for Executives

13.06.2017 | Event News

Global Learning Council Summit 2017

13.06.2017 | Event News

 
Latest News

Study shines light on brain cells that coordinate movement

26.06.2017 | Life Sciences

Smooth propagation of spin waves using gold

26.06.2017 | Physics and Astronomy

Switchable DNA mini-machines store information

26.06.2017 | Information Technology

VideoLinks
B2B-VideoLinks
More VideoLinks >>>