Fixed aneurysm, no surgery: Russell's story

Russell Anderson says he never physically felt his abdominal aortic aneurysm (AAA). But mentally, he always felt "a bit nervous" about it.

"Will what I do make it blow up?" Anderson feared as he did yard work and repairs at his home in Elk River, Minn. But a new, non-surgical technique has relieved much of that worry.

Five worried years

Anderson found out he had an abdominal aortic aneurysm five years ago, when it showed up on a CT scan for a different medical problem.

An abdominal aortic aneurysm (AAA) is a weakening of the lower section of the aorta. The aorta leads down from your heart to the arteries that branch out to your kidneys, abdomen and legs. With AAA, the weakened part of the aorta balloons out and gets weaker. Over time, the aneurysm can grow bigger and rupture without warning, causing deadly internal bleeding.

When Anderson found out about his AAA, it was considered too small to treat. "Until an aneurysm is a certain size, the risks of surgery are greater than of it bursting," he says.

Anderson's doctor checked the aneurysm every six months. The last time, he advised Anderson to have it treated.

"He told me that if it started to leak to try to get to the hospital, but I probably wouldn't make it," he said.

Non-surgical repair

Typically, it takes a three- to four-hour surgery to fix an abdominal aortic aneurysm (AAA). The patient is put to sleep under general anesthesia. A surgeon replaces the weakened wall of the aorta with a hollow tube made of strong fabric.

"AAA surgery is extremely traumatic, and most of the people who have AAAs are older and don't tolerate it well," says Dan Dulas, MD. "The survival rate for ruptured AAAs is dismal, about 10 percent. So we are always looking for minimally invasive ways to treat them."

Dulas and Abdel Akef, MD, both of Metropolitan Cardiology Consultants, repair abdominal aortic aneurysms without surgery. On Feb.13, 2006, they fixed Anderson's aneurysm at Mercy Hospital.

"I was semi-awake the whole time, and I didn't feel anything," says 73-year-old Anderson. "I left the hospital the next day – on Valentine's Day – without pain medication or stitches."

During the procedure in Mercy's cath lab, Dulas and Akef used two half-inch incisions to enter the iliac arteries in Anderson's legs. They then placed a metal device covered with a thin material into Anderson's aneurysm.

The device started out in two parts.

• Dulas sent the first part into the artery of one of Anderson's legs and guided it into the aorta.
• Akef placed the second part into the artery of Anderson's other leg and connected it to the first part.

The completed device is shaped like a pair of pants. The top of the pants is in the aorta and the legs are in the descending arteries. The device prevents blood leakage and relieves pressure on the aneurysm, making it less likely to burst.

There are no long-term studies to show how long the device, the Gore Excluder® AAA Endoprosthesis, will last. But it has a 20-year history in traditional surgery for abdominal aortic aneurysm.

"It's time tested and it works," says Akef.

More importantly, Anderson says, "I feel a lot better now."

Related Links

Abdominal aortic aneurysm

Cardiovascular disease specialists

Mercy Hospital: Cardiac Catheterization Lab

First published: 03/22/2006
Last updated: 03/22/2006

Reviewed by: Paul Kleeberg, MD, medical director, Allina.com