Question: Are there Md.'s in the NYC area who do fenestrated abdominal aortic aneurysm grafts similar to the procedure used at Johns Hopkins? My Father has been recently diagnosed-- TODAY- with an aortic aneurysm. Thanks. XXXXXXX The Hpkins article mentioned 13 hospitals and I saw NYU mentioned as a participant in a study.I do know there are certain charateristics about the position of the aneurysm and its distance from kidney vessels, so my Father will have to be further analyzed.

I assume that since my search skills are good I should br able to find the answer. Also, as a High Schl Teacher, I have not been paid since XXXXXXX however it is MY FATHER!

Thanks for all the names. I have 2 follow up questions.

1] the discussion from the XXXXXXX website does mention an issue concerning a distance from the renal arteries to secure the stent-graft. You claim there is no issue. Could you please clarify this difference.

2] Below the XXXXXXX discussion, they list Columbia Pres., Dr. XXXXXXX McKinsley. Any reason you did not mention this program?

I believe my $18 contract paid for 2 followup questions. Thanks. XXXXXXX

EMAIL: YYYY@YYYY


1] XXXXXXX

Previously, many of those people who were fortunate enough to have their aneurysm identified prior to rupture could not have the endovascular repair because their aneurysm was located too close to the renal arteries. For them, the only option has been open surgery, which carries higher risk of heart attack and kidney failure.

"We need at least 5 millimeters to 10 millimeters of length between the renal arteries and the aneurysm in order to secure the stent-graft in place in most patients," says Johns XXXXXXX vascular surgeon XXXXXXX Black.

Only a few dozen surgeons nationwide, including Black, have been trained to repair abdominal aortic aneurysms with a new type of graft that was FDA-approved in April 2012. Johns XXXXXXX is one of a select group of hospitals in the United States now offering this new approach to patients.

The new graft looks similar to the traditional endovascular graft made of a polyester fabric encased by a stainless steel scaffold. However, it is different from the off-the-shelf graft because of fenestrations — two tiny holes fabricated in the graft to accommodate the renal arteries, helping to keep the graft in place, as well as a scallop-shaped cut to supply blood to the superior mesenteric artery, which carries blood to the intestines.

"We do a substantial amount of planning before the endovascular operation to ensure that the graft will be engineered correctly to match the patient’s individual anatomy," says Black. "The planning process includes making a 3-D image and model of the patient’s aorta using computed tomography (CT)."

The fabrication of each graft takes about five weeks, but for patients it’s worth the wait to have a less invasive repair. They can go home from the hospital three days later and get back to their normal activities in two weeks compared with a four- to eight-week recovery following open surgery. Patients have a CT scan one to two months after the procedure and then are followed annually.

Patients who are eligible for the new customized graft repair include those whose aneurysms approach within 5 millimeters of the renal arteries and have large enough vessels to deliver the stent-graft to the appropriate location.

"At XXXXXXX we perform close to 100 open abdominal aortic aneurysm repairs each year for patients who are not eligible for the minimally invasive option," says Black. "With the new fenestrated stent-graft, we will be able to spare many of those patients a big operation and a long recovery."

2] COLUMBIA MEDICAL CENTER

Until recently, major abdominal surgery was necessary to treat certain abdominal aortic aneurysms. NewYork-Presbyterian Hospital/Columbia University Medical Center is now one of only three hospitals in the nation to provide a “safer, less stressful way of treating patients, some of whom may not be eligible for open surgery.” That is according to XXXXXXX F. McKinsey, MD, Chief, Division of Vascular Surgery and Endovascular Interventions, speaking about treating abdominal aortic aneurysms with a minimally invasive procedure using the fenestrated endograft.