Saturday, March 17, 2012

Minimal Invasive Techniques for repairing aneurysm

Rupture of aneurysm on a major blood artery is a dead sentence and discovering and fixing the blood vessel before a rupture is very important. Just a few years ago the only way for fixing aneurysm, abnormal widening or ballooning of a portion of an artery due to weakness in the wall of the blood vessel, was open surgery but with the introduction of minimum invasive methods, sometimes a few needle punctures are needed to access the artery, even the sickest patients who may have not survived the open surgery can be helped now. This is important since many patients with aneurysm tend to be elderly people with other serious health problems such as diabetes or heart disease.

Aneurysm is a silent killer. If it occurs near the surface, the patient may feel pain and swelling and a throbbing mass is often seen. Unfortunately, aneurysms within the body or brain often cause no symptoms.[2] Risk factors for an aneurysm include diabetes, obesity, hypertension, tobacco use, alcoholism, high cholesterol, copper deficiency, and increasing age.[citation needed] Some types are the result of congenital, or inherited, weakness in artery walls.[3]

The death rate during the repair of a ruptured aneurysm by endovascular surgery is less than 50 per cent of repair by open surgery. There are now dedicated medical teams in many Singapore hospitals specialized in aneurysm and treatment of this condition with minimal invasive techniques. For example, Singapore General Hospital (SGH) has a dedicated team led by vascular surgeon Benjamin Chua and interventional radiologist Manish Taneja performing complicated aortic aneurysm surgery. And since March 2011, they have had about 35 patients who have undergone minimally invasive aortic aneurysm surgery. 22 of these patients required complex work using custom made stent grafts or special techniques:

"Of the 35, three had ruptured aneurysm. Of the three, two had infected aneurysms. One had a gall bladder infection and the other had tuberculosis, which caused the aneurysm to be infected. The oldest patient was 84 years old and the youngest patient was 17 years old. All are doing well"[1]

Aneurysm repaired by stents - Source Singapore General Hospital
SGH has a hybrid operating theatre combining high quality imaging with full surgical facilities. This makes endovascular surgery easier. This hybrid operating theater set up enables a vascular surgeon performing minimal invasive procedure to switch to open surgery easily and provides high quality X-ray imaging facility for complex endovasvular procedures. Such a centre is set up in December in National University Heart Centre Singapore (NUHCS).

[1] - Shoring up a weak vessel, The Straits Times
[2] - Aneurysm
[3] - Aneurysm

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