EL PASO, Texas -- William Beaumont Army Medical Center became the first military treatment facility in the Department of Defense to use the first "off-the-shelf" aortic branch device (stent graft) indicated for the endovascular treatment of common iliac artery aneurysms, April 18.
Vascular surgeons at the hospital successfully performed Endovascular iliac artery Aneurysm Repair (EVAR) on a 60-year-old male patient who elected to employ the new stent graft for his surgery.
"We successfully placed the graft in our patient, preserving blood flow to the pelvis," said Lt. Col. Gilbert Aidinian, chief of vascular surgery, WBAMC. "It was the first time a military hospital was able to do such a thing."
The minimally invasive surgery was performed by Aidinian and Col. Patrick Cook, vascular surgeon, WBAMC.
The aorta is a large artery that carries blood to the abdomen, pelvis and legs. An aortic aneurysm is when part of this artery becomes too large or balloons outward. Common iliac arteries are located just below the abdomen, in the pelvis.
"Any type of aneurysm is when an artery is 1 � times the normal size, if it dilates more the rupture rate increases," said Aidinian, 43, native of Los Angeles. "Most aneurysms are abdominal aneurysms. As many as 20 percent of patients with abdominal aortic aneurysms also have iliac artery aneurysms, which are aneurysms in the pelvis."
Traditionally, abdominal aortic aneurysm repair involved open surgery with an incision through the abdomen resulting in extended recovery time. While the practice of deploying a stent graft through the inside of the aorta is still relatively new, prior EVARs treating common iliac artery aneurysms were not standardized, and often required occluding the internal iliac artery.
"If you block the internal iliac artery, up to 50 percent of patients could develop buttock pain when they walk or develop sexual dysfunction," said Aidinian. "I always need to tell patients, 'you're going to have pain when you walk,' but we treat them and prevent a rupture which is the main concern at the time.
"Lifestyle is important, people having pain when they walk is a big problem," added Aidinian.
Because of the recent approval by the Food and Drug Administration of the iliac branch stent graft, doctors will be capable of preserving blood flow in the external and internal iliac arteries, which branch off from the common iliac artery, greatly reducing the possibility of pain and sexual dysfunction after surgery.
"We now have another state-of-the-art technique to offer our patients," said Aidinian. "This procedure allows the patient to go home the next day."
Fourteen days after the first patient's one-day stay, Aidinian reports he is recovering well.
"We're very well trained and certified in using these types of grafts," said Aidinian. "Since this is approved by the FDA and it will become the standard of care. We are the first ones (in the DOD) offering it to our Soldiers, retirees, families and VA beneficiaries."
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