A patient of 79 years suffering from an abdominal aortic aneurysm has been the beneficiary of this pioneering operation, impossible until now due to the angularity of the patient's arteries.

The Hospital Clínic de Barcelona has implanted what can be considered the lowest-caliber prosthesis on the market to a 79-year-old patient suffering from an abdominal aortic aneurysm -with a dilatation of 52 mm in the aorta- difficult to access due to angularity and narrowness of its arteries, in a pioneering operation in the world, only carried out simultaneously in Germany.

The head of Vascular Surgery of the Clinic and leader of the operation, Vicenç Riambau, has explained that it is a minimally invasive intervention to which the patient could not have been subjected without this application, so it would have required an open surgery with more risk, complications and postoperative.

This technological evolution represents a breakthrough for vascular surgeons who treat patients whose arteries have difficult access being more angular and narrow, as is the case of women and some men, especially older, explained Riambau.

The surgeon has also stressed that this innovation is positive for all patients candidates to receive a stent, since in the smallest caliber of the implanted catheter - six millimeters (equivalent to a pencil), "one less than those used until now - can reduce the damage, "he added.

The patient of 79 years was diagnosed in another center the aneurysm of 52 mm in diameter and another associated with the right iliac artery of 33 mm. However, his femoral arteries and the external iliac arteries were of marked tortuosity and small caliber - only six millimeters. His pathological background included an ischemic heart disease that required two coronary bypasses and a chronic lung disease under medical treatment with bronchodilators.

Given the clinical and anatomical complexity of the case, the patient was referred to the Clínic for endovascular treatment. The surgery was carried out with a type of anesthesia that allowed the patient to remain conscious all the time and was discharged at 36 hours. The intervention, of 55 minutes, consisted in the introduction by the groin of the catheter -innovation of the American Cook Medical- to make it ascend to the area of ​​the aneurysm through a guided camera. Upon reaching the area blocked by a more lubricated layer, the medical team deployed the 'stent' - nitinol tube - coated with fiber and cloth - polyester - as if it were an umbrella to prevent a rupture of the artery.

At the end of the intervention, the patient remained in the recovery room for six hours and was later transferred to the normal hospital ward where he could dine slightly. After 36 hours he left the hospital by his own feet.

What is an aneurysm?

It is the dilatation of the arteries, a consequence of the weakening of its walls by arteriosclerosis. The aorta, the main artery of the body, originates in the thorax and down to the abdomen.

Abdominal aortic aneurysms are the most frequent, between five and ten percent of men over 65 suffer from it. The most important complication is the rupture of the aorta, which is associated with a very high mortality, close to 90 percent of cases.


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