Groundbreaking Endovascular Iliac Branch Aneurysm Repair Takes Place In Scotland

Main Category: Vascular
Article Date: 14 Feb 2008 - 1:00 PST

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A vascular surgeon at Lanarkshire Hospital has carried out the first endovascular iliac branch aneurysm repair operation in Scotland. Dr Stephen Kettlewell, Vascular Surgeon and Deputy Clinical Director of surgery for NHS Lanarkshire, along with Dr Fong Lau, Radiologist, carried out the endovascular repair operation using a Zenith Branch Endovascular Graft device from the Aortic Intervention business unit of Cook Medical, the global leader in endovascular therapy products. This procedure is extremely rare, with only a handful carried out in the UK to date. It highlights the patient benefits of minimally invasive endovascular aneurysm repair techniques as opposed to highly traumatic open surgery for this life-threatening disease.

Stephen Kettlewell's patient was Mr Fleming, a 67 year old who suffered from an aneurysm in the abdominal aorta which extended into his iliac arteries. The operation started at 8.30 am and lasted five and a half hours, during which he was awake throughout. Mr Fleming recovered normally and left hospital. Once home, he has made a good progress toward his normal lifestyle, an option open surgery would have made more difficult.

Stephen Kettlewell explains: "Abdominal aneurysms are a common cause of death amongst men over 65 in the UK. They're silent killers as there are often no symptoms - the first time many aneurysm patients know they have it is when it ruptures, from which there is an 80% chance of death. The good news is that, if detected during a routine, painless ultrasound screening, aneurysms are relatively easy to repair. Mr Fleming's condition is, thankfully, less common, but much harder to repair whilst maintaining a good quality of life as traditional stent-grafts, when inserted into the leg arteries to treat the aneurysms there can sometimes block off blood supply to areas of the legs and buttocks, causing problems from severe leg and buttock pain to impotence.

"Cook Medical's Zenith Branch device is the only stent-graft available that allows a surgeon to repair an iliac branch aneurysm whilst still maintaining a good flow of blood to these arteries in the leg. This operation is the first of its kind in Scotland - the procedure was proctored by Dr Ferdinand Serracino-Inglott, vascular surgeon at Manchester Royal Infirmary, who as one of Europe's most experienced vascular surgeons in this area, has carried out similar operations across England and Ireland.

"Mr Fleming is now back at home, fully recovered and enjoying an aneurysm-free start to the year".

What is an aneurysm?

An aneurysm is a dangerous bulge in the aortic wall caused by blood pressure pushing against a weakened area. Most standard aortic aneurysms occur in the chest (a thoracic aortic aneurysm - TAA) or in the abdomen (an abdominal aortic aneurysm - AAA). However in some AAA cases, the aneurysmal disease can extend down into the iliac arteries, which supply blood to the legs. This is a more complex condition to repair, especially when the iliac aneurysm extends beyond the iliac arteries and involves the lower part of the arteries.

How is an Aneurysm Repaired?

To repair an aneurysm, a stent-graft is guided into the body. Once inserted into the aorta, a stent-graft - a tubular fabric device supported by self-expanding metal stent bodies - seals off the aneurysm from within, relieving blood pressure against the weakened walls of the aorta, the body's main blood vessel.

About the Operation and Device

The operation was performed using Endovascular Aneurysm Repair (EVAR), a relatively new procedure gaining wide acceptance in the medical community in the UK and around the globe. Traditional open surgery, which involves a general anaesthetic and making a large incision in the abdomen to clamp off the aorta and replace the damaged section with a surgical graft, can lead to serious complications and extended recovery times. Instead, Mr Fleming was treated using minimally invasive endovascular therapy, with the medical team inserting catheters via two small incisions in the groin to access the femoral arteries. Radiologists inserted guidewires through the two incisions, with Dr Lau, aided by Mr Serracino Inglott, inserting the delivery system carrying the stent-graft precisely into position over the guidewires, where the device was deployed to treat the aneurysm. This kind of endovascular repair frequently results in less patient discomfort and complications, a shorter hospital stay and faster recovery than undergoing the more traumatic open surgery.

About Cook

Cook Medical was one of the first companies to introduce interventional devices in the United States. Today, the global company integrates device design, biopharma, gene and cell therapy and extracellular matrix technology to enhance patient safety and improve clinical outcomes in the fields of aortic intervention; interventional cardiology; critical care medicine; gastroenterology; radiology, peripheral vascular, bone access and oncology; surgery and soft tissue repair; urology; and assisted reproductive technology, gynaecology and high-risk obstetrics. Cook is a past winner of the prestigious Medical Device Manufacturer of the Year Award from Medical Device & Diagnostic Industry magazine.

Cook Medical

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