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New Jersey’s First Percutaneous Endovascular Repair Livingston, N.J. —The Department of Surgery at Saint Barnabas Medical Center announces that Steven M. Hertz, M.D., Director of the Division of Vascular Surgery and President of N.J.’s State Vascular Society, performed New Jersey’s first percutaneous (meaning "through the skin") endovascular repair of an abdominal aortic aneurysm on 81-year-old Seymour Cutler on June 22, 2006. This minimally invasive alternative is available in only a select group of leading medical centers in the United States. In standard endovascular repair of an abdominal aortic aneurysm, the surgeon makes two small incisions in the groin area to perform 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. “As the technology improves, the devices we use continue to get smaller and less traumatic to the vessels,” says Dr. Hertz. “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.” 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 Patient’s Story Originally his aneurysm was discovered several years ago during some tests before back surgery. The aneurysm was monitored every six months until it increased to a dangerous size. The Cutlers cancelled their vacation and scheduled the surgery. “I am very pleased by the outcome and that it went the way it did,” says Mr. Cutler. He added that it was “unbelievable” that he only needed “two Band-Aids” to cover the area where the procedure took place. Now Mr. Cutler is back volunteering at Saint Barnabas where he has completed 6,000 hours of service since his retirement. He is known around the Medical Center for the 300 colorful pins he wears on several different volunteer vests. The Procedure 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. When an abdominal aortic aneurysm is small, it needs to be monitored with periodic scans to make sure that the aneurysm does not enlarge to a size that represents a higher risk for rupture. When an aneurysm enlarges beyond a certain size--often 5 centimeters across is used as the threshold--the benefits of repair are felt to outweigh the risks of the procedures-- then repair of the aneurysm is generally advised. Some facts about abdominal aortic aneurysms: For a referral to an attending vascular surgeon from Saint Barnabas, please call 1-888-SBHS-123. Date: June 24, 2006 [ top ] |
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