U. doctors use new technique to repair an aortic aneurysm

New, less invasive procedure was tested on an 82-year-old patient and provided the same results as open surgery without the risks. Combining techniques used in interventional radiology and vascular surgery, physicians at the University's Medical Center used a minimally-invasive method to repair an aortic aneurysm -- a condition where a vein or artery weakens, balloons out and is in danger of bursting. The breakthrough was motivated by the desire to help 82-year-old Paul Bachman -- a lifelong smoker with chronic lung disease who was deemed too weak to withstand the open surgery that is traditionally performed to repair the condition. But doctors hope it will become the standard of care for all patients with aortic aneurysms. Jeffrey Carpenter -- a professor of surgery at the University's School of Medicine who assisted in the operation -- explained that the new technique achieves the same results as open surgery without the risks. "Although we're using specially crafted apparatus, we're making the same kind of repair that is accomplished with surgery," he said. "The important difference is that instead of working from the outside of the patient, we work from the inside." Richard Baum -- a professor f radiology at the University's School of Medicine created a graft consisting of self-expanding wire stents -- tiny, stainless steel scaffolds -- which were sewn together and encased in a stretchable teflon cover. The graft was compressed, put inside a narrow tube, and inserted into the aorta through a small incision in the leg. Baum and Carpenter used X-ray guidance to move the tube up the aorta until it reached the aneurysm in the abdomen. The tube connects normal areas of the aorta and allows blood to bypass weak parts, preventing the aneurysm from bursting. Baum explained that the new technique also eliminates the need for lengthy hospitalization during the recovery period. Patients who undergo open surgery to repair aneurysms are typically hospitalized for at least one week -- including several days in the intensive care unit -- followed by a six-week rehabilitation period. But Baum said Bachman required no formal recovery period and was discharged from the Hospital of the University of Pennsylvania two days after the procedure. "We kept Mr. Bachman in the intensive care unit overnight, but I'm not sure he needed to be there," Baum said. "Since he was our first patient, we wanted to observe him and make certain there would be no complications associated with the new technique, and indeed there were none." Carpenter added that the success with Bachman has prompted an ongoing clinical trial of the procedure for high-risk aneurysm patients. "Most of the patients who are too sick to undergo the traditional operation are killed by the aneurysm when it ruptures, not by the disease that is compromising them," he said. "We hope this procedure will make every aortic aneurysm patient a candidate for repair."