The vascular surgeons at Northwestern’s Bluhm Cardiovascular Institute were the first in Chicago to treat aortic aneurysm patients with endovascular repair . This minimally invasive procedure has the potential to allow for a shorter hospital stay and faster recovery when compared to traditional open surgical repair of aneurysm. Endovascular repair has become the most common treatment for aortic aneurysms and is performed on more than 70 percent of patients with aortic aneurysms in the United States.
Instead of a large incision associated with an open repair, with endovascular repairs, surgeons create smaller incisions near the hips and place a sheath with a graft in the femoral arteries. The graft is advanced through the arteries to the blood vessels where the aneurysm is located. The graft is used to seal the aneurysm, making a new path for the blood to flow.
Zenith Fenestrated AAA Endovascular Grafts
The Zenith Fenestrated AAA Endovascular Graft is a unique type of endovascular graft developed for patients with abdominal aortic aneurysms (AAA) that, to this point, would not have been be candidates for endovascular repair. In particular, the Zenith Fenestrated Graft allows endovascular treatment of aneurysms that are near the arteries providing blood flow to the kidneys. Blood flow to the kidneys is maintained after the repair is complete.
- A proximal body graft
- A distal body graft
- Iliac limb grafts
- Renal artery stent-grafts
The proximal body is custom manufactured to a patient’s specific anatomy based on the size and position of the aorta and its branch arteries to the kidneys and intestine.
The custom measurements for each graft are made based on a high resolution CT scan performed before surgery.
The distal body connects to the proximal body, providing continued blood flow into the iliac arteries, which provide blood flow to the pelvis and legs. The iliac limb grafts connect to the distal body, providing a seal in the iliac arteries. The renal artery stent-grafts help to seal the top of the aneurysm repair while maintaining blood flow to the kidneys.
How Endovascular Grafts Are Placed in the Body
Your doctor will measure your aorta and its branch arteries using a high resolution CT angiogram (a test to visualize the arteries and veins of the body) to design a custom graft that is appropriate for your anatomy. No two patients are the same, and careful measurement at this stage is critical for good results.
To place the graft in the body, your doctor will make a small incision near each hip, near the crease between your abdomen and thigh, to access the femoral arteries (which provide blood flow to the legs and feet). Each part of the graft is inserted separately into your bloodstream through these incisions, and each part of the graph comes in its own plastic sheath. Once in the body, the sheath is removed allowing the graft the open creating a new lining within the aorta to seal off the aneurysm.
Your doctor will use x-rays to confirm that the blood is flowing to the branch vessels and iliac arteries, and to make sure that blood is not flowing into the aneurysm. Then your doctor will close up the incisions used to place the graft.
Some possible complications of the Zenith Fenestrated AAA Endovascular Graft may include:
- Blood transfusion (16–20 percent possibility)
- Decreased or absent blood flow to the renal artery (11–15 percent possibility)
- Abnormal or irregular heartbeat (5–10 percent possibility)
Benefits of Endovascular Treatment
Endovascular aneurysm repair is designed to eliminate the chance of future aneurysm rupture.
Additional benefits include:
- Faster return to normal daily activities
- Improved clinical outcomes
- Less blood loss
- Less pain
- Shorter recovery time
- Smaller incisions with less scarring
Follow-up for Endovascular Treatment
If you receive a Zenith Fenestrated AAA Endovascular Graft, you will need regularly scheduled follow-up to monitor your repair. Follow-up appointments may include a CT scan or abdominal ultrasound to ensure that the repair remains in good position and that there is good blood flow through all graft components.
Talk with your doctor if you have any health concerns regarding these regular checkups. They should be considered part of a lifelong commitment to your health, and are necessary to allow your doctor to evaluate your treatment and any changes you may experience over time.
If you experience one of the following symptoms, you should contact your doctor immediately:
- Pain in legs, abdomen or chest
- Numbness in legs, abdomen or chest
- Weakness in legs, abdomen or chest
- Rapid heartbeat
- Leg discoloration or coolness
- Decreased urination
Ongoing clinical research trials at the Center for Vascular Disease are investigating new treatments options for abdominal aortic aneurysms to ensure that our patients continue to receive the most innovative care in the country. For more information regarding these clinical trials, visit the Clinical Trials Unit of Northwestern, send an email or call 312-926-4000.
Contact Us Today
For more information regarding abdominal aortic aneurysms and the Zenith Fenestrated AAA Endovascular Grafts or to schedule an appointment, please contact the Bluhm Cardiovascular Institute at 866-662-8467 or request a first-time appointment online.
*Permission for image use granted by Cook Medical Incorporated, Bloomington, Indiana