Straub Introduced Life Saving Surgery to Hawaii

The aorta is the major artery that carries blood from the heart. Each year, more than 50,000 Americans undergo surgery to repair potentially deadly aortic aneurysms, a ballooning of the artery caused by weakness in its wall.

Almost as many people die each year from aneurysms as from breast cancer and AIDS. In fact, aneurysms are among the top 10 causes of death for men ages 55 and older. Celebrities Lucille Ball and Conway Twitty, and scientist Albert Einstein all died from aneurysms.

Traditional surgery to repair the aneurysm requires a long vertical incision through the abdomen. The aneurysm is replaced by a woven polyester tube called a graft. The traumatic procedure requires a week-long hospital stay, and four to six weeks of recovery time at home.

The new procedure, successfully performed at Straub, is designed to prevent rupture and bleeding of the aneurysm, hasten recovery and reduce pain to the patient. This procedure repairs the aneurysm by accessing the patient's leg artery through a small incision in the groin. A catheter is fed into the artery up to where the aneurysm is located. Then, the woven graft is fed inside the catheter up to the aneurysm. Physicians observe the position of the graft and move it into place with the aid of fluoroscopy, a type of X-ray. Once in position, the graft expands thanks to a wire spring-like device sewn into the graft. As the graft expands, it hooks onto the inside wall of the artery above and below the aneurysm. The result is that the blood that previously flowed through the aneurysm, now flows through the graft. With the blood pressure on the aneurysm relieved, the aneurysm can now shrink and the graft becomes the permanent lining of the artery.

This much less traumatic procedure enables a quicker recovery and is less painful to the patient. "Most patients leave the hospital two days following surgery," notes Elna Masuda, MD, Straub vascular surgeon, "and they're back to work in a week or two."

In addition, the new procedure makes it possible for a whole new group of patients to have their aneurysms repaired. These are patients whose other medical problems have prevented them from having the traditional surgery. In these cases, physicians have had no alternative but to tell the patient to avoid activities that would cause the aneurysm to enlarge. The danger is that the aneurysm bursts. Almost eighty percent of all aneurysms that rupture, result in a patient dying from internal bleeding.

It's unclear what causes an artery wall to weaken and form an aneurysm, but it is recommended that people with pulmonary disease, high blood pressure or a family history of aneurysms be screened thoroughly.

Most patients the majority being men ages 40 to 70 have no early warning symptoms of an aneurysm. Reports show that pain in the stomach or back can signal an upcoming rupture of the abdominal area. Aneurysms can generally be detected with a physician's exam and ultrasound.

To make an appointment at the Vascular Center, call (808) 522-4469 or the 24 hour appointment line at (808) 522-4777.