In an aortic aneurysm the walls of the aorta, the primary blood vessels leading away from the heart, bulge out like a filling water balloon. Eventually it bursts, usually causing a fatal bleeding episode.
Using a wire-thin catheter, the UCSF team inserted a specially designed graft through the right carotid artery on the side of the neck. The graft, a fabric tube that incorporates metallic threads (to offer structural support), was then guided into the arched part of the aorta, which carries blood to the head and body from the heart. Once in place, this specially designed structure, also called a stentgraft, expanded to reinforce and reline the interior walls of the arch.
"While stentgrafts are now commonly used to treat aneurysms of the aorta within the abdomen, using stentgrafts to treat aneurysms of the aortic arch has presented special problems because of its large size, curved shape and its critical branches that supply blood flow to the brain," said Darren Schneider, MD, a vascular surgeon at UCSF Medical Center and lead author of a paper which appears in the October issue of the Journal of Vascular Surgery.
"In particular, we had to develop a device capable of repairing the aorta without hampering the blood flow through blood vessels that branch out from the aortic arch to supply blood to the brain and arms."
The aortic arch repair represents the first time a U.S. patient's entire aortic arch has been successfully repaired using a minimally invasive branched stentgraft technique. A surgeon from Japan first reported an endovascular stentgraft repair of the entire aortic arch in 1999 using a complex technique that has not been replicated, according to Schneider.