Y
Yaps
http://news.yahoo.com/s/ap/20050818/ap_on_he_me/barricading_aneurysms
PHILADELPHIA - A device that resembles a child's finger trap toy is being used to treat a type of heart aneurysm that often grows without any symptoms until it bursts, usually with fatal consequences.
The Food and Drug Administration in March approved the stent, and the University of Pennsylvania has now begun FDA-required training for surgeons nationwide on how to use it. A flexible tube that comes in a range of lengths and diameters, it can be used for a specific kind of aneurysm that pops out from the aorta ? the body's main artery.
The device, manufactured by W.L. Gore and Associates Inc., of Flagstaff, Ariz., is made of Teflon-like material with an outer metallic support structure. It is the first FDA-approved grafting system for treating aneurysms of the descending thoracic aorta.
Thoracic aortic aneurysms are diagnosed in approximately 15,000 people annually. Because they often cause no symptoms, they are typically spotted when a patient is being treated for another condition.
If the aneurysm bursts, the person can quickly die of internal bleeding.
"The treatment options have been either open surgical repair or no repair at all," said Dr. Joseph Bavaria, a Penn cardiac surgeon and one of the lead investigators during trials of the device.
"We'd operate when the risk of rupture was greater that the risk of surgery ... or we put patients on blood pressure medication and hoped for the best," he said.
Penn is one of seven facilities nationwide training doctors about the device.
The device had fewer deaths than surgical treatments, less blood loss, a shorter hospital stay and quicker recovery. Unlike open surgery, the stent can be implanted under local anesthesia.
It's also an option for elderly patients and others who would be unable to withstand the traditional surgery, which involves making a 12- to 14-inch-long opening in the chest and removing the diseased part of the aorta while the patient is kept alive on a heart-lung machine, Bavaria said.
To implant the new device, doctors make a two- to three-inch incision in the patient's abdomen or groin and guide a catheter with the compressed stent through an artery and into the diseased part of the aorta. When they withdraw the catheter, the flexible stent springs open and expands to the width of the aorta, creating a new aortic lining and sealing off blood flow into the aneurysm "bubble."
Without blood to feed it, the bubble typically shrinks over time, said Dr. Jeffrey Carpenter, a Penn vascular surgeon who also was involved in the clinical trials.
Precise placement is crucial: Once the stent is expanded, it cannot be readjusted. Doctors test on computer models before surgery to see what stent length and diameter will work best; in the operating room they guide the stent to the proper position by real-time X-ray images viewed on a monitor.
Since the stent has been used in trials only since 1999, it's unclear how long it will last. However, Bavaria said the device has held up so far in patients who have gotten it in the past three to four years.
Bill Tinker, 70, of Embreeville, Chester County, was treated with medication for five years because doctors believed he wouldn't survive open surgery for his aortic aneurysm. Told he had two weeks to live without intervention, he underwent the stent surgery a little over a year ago and called the results "amazing."
"I had to drive in the right hand lane so if it burst, I could pull over and not kill someone else," he said. "Now, I can drive in the passing lane."
PHILADELPHIA - A device that resembles a child's finger trap toy is being used to treat a type of heart aneurysm that often grows without any symptoms until it bursts, usually with fatal consequences.
The Food and Drug Administration in March approved the stent, and the University of Pennsylvania has now begun FDA-required training for surgeons nationwide on how to use it. A flexible tube that comes in a range of lengths and diameters, it can be used for a specific kind of aneurysm that pops out from the aorta ? the body's main artery.
The device, manufactured by W.L. Gore and Associates Inc., of Flagstaff, Ariz., is made of Teflon-like material with an outer metallic support structure. It is the first FDA-approved grafting system for treating aneurysms of the descending thoracic aorta.
Thoracic aortic aneurysms are diagnosed in approximately 15,000 people annually. Because they often cause no symptoms, they are typically spotted when a patient is being treated for another condition.
If the aneurysm bursts, the person can quickly die of internal bleeding.
"The treatment options have been either open surgical repair or no repair at all," said Dr. Joseph Bavaria, a Penn cardiac surgeon and one of the lead investigators during trials of the device.
"We'd operate when the risk of rupture was greater that the risk of surgery ... or we put patients on blood pressure medication and hoped for the best," he said.
Penn is one of seven facilities nationwide training doctors about the device.
The device had fewer deaths than surgical treatments, less blood loss, a shorter hospital stay and quicker recovery. Unlike open surgery, the stent can be implanted under local anesthesia.
It's also an option for elderly patients and others who would be unable to withstand the traditional surgery, which involves making a 12- to 14-inch-long opening in the chest and removing the diseased part of the aorta while the patient is kept alive on a heart-lung machine, Bavaria said.
To implant the new device, doctors make a two- to three-inch incision in the patient's abdomen or groin and guide a catheter with the compressed stent through an artery and into the diseased part of the aorta. When they withdraw the catheter, the flexible stent springs open and expands to the width of the aorta, creating a new aortic lining and sealing off blood flow into the aneurysm "bubble."
Without blood to feed it, the bubble typically shrinks over time, said Dr. Jeffrey Carpenter, a Penn vascular surgeon who also was involved in the clinical trials.
Precise placement is crucial: Once the stent is expanded, it cannot be readjusted. Doctors test on computer models before surgery to see what stent length and diameter will work best; in the operating room they guide the stent to the proper position by real-time X-ray images viewed on a monitor.
Since the stent has been used in trials only since 1999, it's unclear how long it will last. However, Bavaria said the device has held up so far in patients who have gotten it in the past three to four years.
Bill Tinker, 70, of Embreeville, Chester County, was treated with medication for five years because doctors believed he wouldn't survive open surgery for his aortic aneurysm. Told he had two weeks to live without intervention, he underwent the stent surgery a little over a year ago and called the results "amazing."
"I had to drive in the right hand lane so if it burst, I could pull over and not kill someone else," he said. "Now, I can drive in the passing lane."
