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New Jersey’s First An attending physician at Saint Barnabas Medical Center performed New Jersey’s first percutaneous endovascular repair of an abdominal aneurysm on an 81-year-old Millburn man, Seymour Cutler, who left the hospital in less than 24 hours with two band-aids covering the site of the procedure. This minimally invasive alternative is available in only a select group of leading medical centers in the United States. “As the technology improves, the devices we use continue to get smaller and less traumatic to the vessels,” says Steven M. Hertz, M.D., Director of the Division of Vascular Surgery and President of N.J.’s State Vascular Society, who performed the procedure on Mr. Cutler. “These technical refinements of the already minimally invasive procedure are beneficial to the patient. This is a dramatic contrast to traditional open aneurysm repair which requires an abdominal incision and several days in the ICU, a substantial procedure for patients in terms of risk and recuperation. The endovascular approach, when feasible, affords the patient the same benefit of surgery with lower risk and a substantially faster and more comfortable recovery.” In standard endovascular repair of an abdominal aortic aneurysm, the surgeon makes two small incisions in the groin area to perform FamilyHealth I 9 the surgery. In percutaneous endovascular repair, the surgeon makes small needle punctures in the skin to insert the device, but does not require a surgical incision. An external suturing device is used to close the opening in the femoral arteries. Endovascular aneurysm repair has allowed the life-saving benefits of surgery to be offered to older patients and those with more advanced medical problems who might not have been candidates in the past, Dr. Hertz relates.
The Procedure Percutaneous endovascular repair of an abdominal aortic aneurysm consists of inserting the catheters and devices needed for endovascular aneurysm repair through a needle puncture in the skin over the groin arteries. A microsurgical device is used to insert sutures through the opening into the arteries. After the aneurysm has been repaired, the openings in the arteries used to pass the aneurysm stent-graft are sealed shut by tightening the sutures previously placed by the external suturing device. Nearly 15,000 Americans die each year from a ruptured abdominal aortic aneurysm. This bulge of the main blood vessel in the abdomen rarely causes any symptoms, until it ruptures. When the abdominal aortic aneurysm is repaired electively, before rupture, the survival rate is greater than 95 percent with traditional surgery, and approximately 99 percent with endovascular methods. If the aneurysm ruptures, the patient survival rate drops to 15 percent to 20 percent. More than 40,000 elective aneurysm repairs are performed each year. SOME FACTS ABOUT ABDOMINAL AORTIC ANEURYSMS:
For a referral to an attending vascular surgeon from Saint Barnabas, please call 1-888-SBHS-123.
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