Patients at Baylor Medicine, the primary multidisciplinary clinical practice of Baylor College of Medicine, and Baylor St. Luke's Medical Center who have experienced complex aortic aneurysms can now be treated with a new stent procedure, endovascular fenestrated and branched stent-grafts, which will repair the aneurysm and preserve blood flow to a person's kidneys and intestinal arteries. These procedures are alternative treatment options to traditional open surgery.
Surgical procedures to repair life-threatening enlargements of the aorta initially took more than eight hours to perform, required incisions that extended from the mid chest to the lower abdomen and required days-long hospitalizations and weeks of recovery.
"Endovascular surgery is less invasive, which means there is less trauma and stress to the patient. There is also less blood loss and essentially almost no incision or very small incisions, which allows us to have a substantially lower risk of complications," said Dr. Gustavo Oderich, chief of the Division of Vascular Surgery and Endovascular Therapy in the Michael E. DeBakey Department of Surgery at Baylor College of Medicine and director of Baylor's Center for Aortic Surgery. "Baylor Medicine is one of the few centers in the country that is privileged to have stents already widely used in Europe and other countries."
Most aortic aneurysms happen below the kidneys, making them easier to repair with a simple endovascular stent. There is no handling of blood vessels that supply critical organs in a person's body. However, when the aneurysm affects the blood vessels above the kidneys, the operation is more delicate as one needs to preserve blood supply to the organs.
Complex aortic aneurysms involve the side branches of the aorta. These may be treated with special stents manufactured with small openings (fenestrations) or side arms (branches) that allow separate bridging stents to be connected into the side arteries. During the endovascular fenestrated and branched stent-grafts procedures, the surgeon places the stent in the aorta in the location of the aneurysm and connects these side branch stents into the blood vessels that supply the liver, intestines and kidneys.
"This procedure involves precision medicine and allows us to tailor treatment specific to a patient," said Oderich, who also is a member of the Texas Heart Institute at Baylor College of Medicine. "There is a custom stent designed to fit the exact anatomy of the patient."
He adds that these procedures will make a difference in patients' lives because of the low 1% mortality rate and the short recovery time. Patients will spend less time in the hospital, around one to four days, and they can resume regular physical activity faster.
"We could not be more thrilled and privileged to welcome Dr. Oderich to Baylor College of Medicine, the birthplace of aortic surgery developed by icons like DeBakey, Cooley and Crawford in the 1950s and 1960s," said Dr. Todd Rosengart, professor and chair of the Michael E. DeBakey Department of Surgery. "The stent technology that Dr. Oderich has helped pioneer represents a miraculous new innovation in treating this deadly disease and a modern-day version of revolutionary advancements of aortic surgery."
"I am excited to bring these procedures to Baylor Medicine because I consider this the next chapter in cardiovascular surgery," Oderich said.
Learn more about Oderich here.
