Abdominal Aortic Aneurysm Repair

“If your garden hose bulges in one spot, it’s obviously weak there,” is how Dr. John You analogizes an aneurysm, the weakening and potential rupture of a blood vessel.

“You can wrap the weak spot on the hose with duct tape to strengthen it. Now, we can do something like that for an aneurysm, too.”

Dr. You is a vascular surgeon at The Scarborough Hospital (TSH), one of only two Toronto hospitals to pioneer a new type of endovascular graft. It gives people another treatment option for abdominal aortic aneurysms.

Anson Taylor, 80, retired Director of Education in Scarborough, recently found himself in Dr. You’s care.

“About 15 years ago, my brother died from an aneurysm,” Taylor says. “When my doctor said ‘aneurysm,’ I knew it was serious. If an aneurysm starts to leak, your chances are not good.”

“I had an illness through the fall (of 2003). Specialists looked at almost every part of my body. We didn’t know there was an aneurysm there.”

Dr. You explains a traditional abdominal aortic aneurysm repair by way of analogy. “To fix a broken pipe in the wall, you knock a hole in the wall, turn off the water, replace the pipe, fix the wall, and turn on the water again.”

“We ‘turn off’ blood flow to the legs, so this operation is as serious as a coronary bypass.”

“Since patients are primarily elderly or ill, they often have other health problems. The traditional repair could do more harm than good. The new method is another option.”

“Under epidural anesthesia, we put two three-centimeter incisions on either side of the groin instead of one long cut down the abdomen. I feed grafts, wrapped thin as a Bic pen, up to the aneurysm through these cuts. Watching on X-ray, I place the grafts at the aneurysm and unsheathe them. They open and stick in place.”

“The bulge is still there, but with blood pressure on the graft now, the aneurysm doesn’t expand further. Most importantly, it won’t burst.”

Taylor recalls: “My wife and I spent two afternoons with the staff at Scarborough who were going to be involved in the operation. Dr. You’s quiet manner, his confidence made me so happy. I felt my chances were much better because he gave me that confidence.”

Both the traditional and endovascular procedures last several hours, but unlike the former, patients who receive the endovascular graft spend no time in intensive care. They stay three days in hospital instead of seven. Both reductions lead to cost savings and less patient stress. Also, “it’s less risky overall,” says Dr. You.

Taylor is pleased. “I was two weeks in the hospital following the procedure. When I left, the improvement was so great! He really is a terrific doctor. He saved my life.”

“We’re one of only 12 centres across Canada to perform this new procedure,” Dr. You continues. It’s new technology, not yet well-known in Canada, “but initial performance indicates that these things will work, and work well, for a number of years.”

Top