Nghe An General Hospital successfully performed the first Stent Graft technique to treat aortic aneurysm.
(Baonghean.vn) - The implementation of aortic stent graft intervention technique has created conditions for patients to choose optimal treatment methods for aortic disease.
June 6, 2022, Cardiovascular Center -Nghe An General Friendship Hospitalreceived patient Tran Thi H., 82 years old, with a history of high blood pressure and obesity for many years. The patient was admitted to the Cardiovascular Center - Nghe An General Friendship Hospital because of persistent dull lower abdominal pain for more than a month.
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Image of abdominal aortic aneurysm on CT scan. Photo: Tat Ngoc |
After examination, Doppler ultrasound, and multi-slice computed tomography of the aorta, the image of a fusiform aneurysm below the origin of the renal artery was shown, with a thrombus attached to the wall. Cardiovascular surgeons, internal cardiologists, and interventional cardiologists of the Cardiovascular Center consulted and agreed on the diagnosis: Abdominal aortic aneurysm below the renal artery bifurcation, with a thrombus attached to the wall in a hypertensive patient. The patient was given a treatment plan of surgical replacement of the abdominal aorta with an artificial segment, or interventional placement of a stent graft into the aorta to treat the aneurysm.
Assessing the condition of an elderly, obese patient with a large, complex aneurysm and high risk of open surgery to replace the abdominal aorta with a long hospital stay and high risks during and after surgery, the interventional cardiologists consulted with the hospital leadership and experts from the Vietnam Heart Institute - Bach Mai Hospital and decided to perform aortic stent grafting.
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Image of abdominal aortic aneurysm on CT scan. Photo: Tat Ngoc |
Stent Graft is a special metal frame, covered with a synthetic fiber membrane, used to place inside the aorta to stabilize the aortic wall, prevent the aneurysm from rupturing and regulate normal blood flow inside. This is a minimally invasive endovascular intervention method, performed by inserting the stent through the femoral artery into the aorta without having to directly open the aorta.
On the morning of June 15, 2022, a team of cardiovascular interventional doctors, under the guidance of Associate Professor, Dr. Pham Manh Hung, Director of the Vietnam Heart Institute, successfully performed the technique of stent graft placement to treat abdominal aortic aneurysm for patient H.
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Image of aneurysm before aortic stent graft intervention on DSA angiography system. Photo: Tat Ngoc |
The procedure was performed smoothly in about 1 hour at the Cardiovascular Intervention Room.Nghe An General Friendship Hospital. The patient is given local anesthesia and the interventional instrument is inserted through the femoral artery on both sides. After taking pictures, measuring and calculating to choose the appropriate size, the stent Graft in a collapsed state in the catheter is inserted through the femoral artery, when the exact position is determined, the stent Graft is gradually released and self-expanded against the wall of the healthy aorta, pulled through the aneurysm down below, then two more stent segments are placed to connect to the common iliac artery on both sides. The patient is examined with contrast agent after placing the stent Graft to ensure that the expanded stent is fully pressed against the abdominal aortic wall, with no leakage.
After the intervention, the patient was alert, able to talk and could stretch her legs after only 2 hours and was able to walk after one day of the procedure. On June 22, after 1 week of monitoring and medical treatment, patient Tran Thi H. was discharged from the hospital in a stable condition, without abdominal pain. An abdominal aortic ultrasound after the intervention showed an image of a stent graft from below the renal artery to the common iliac artery on both sides, no leakage, good stent patency, flow velocity and Doppler spectrum within normal limits.
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Image of aneurysm after aortic stent graft intervention on DSA angiography system. Photo: Tat Ngoc |
Associate Professor, Dr. Pham Manh Hung, Vietnam Heart Institute said:“Aortic aneurysm is a dangerous disease with a high risk of death. The patient can die suddenly if the aneurysm ruptures.The incidence of new cases in Vietnam is about 4,000-5,000 patients per year. Currently, there are two methods of treating abdominal aortic aneurysm: traditional surgery to cut the aneurysm and replace it with an artificial vessel or placing an aortic stent graft. Aortic replacement surgery is a major, radical surgery, but the risk of death is high, especially in elderly patients with many comorbidities. With the continuous development of science and technology, the stent graft method is becoming more and more popular and shows its superiority in treating aortic aneurysm. The procedure time is short, patients can move and be discharged early. This method is especially effective for elderly patients with many risk factors.
Dr. Pham Hong Phuong - Deputy Director of the Hospital - Director of the Cardiovascular Center of Nghe An General Hospital shared: Currently, the Center has deployed many advanced techniques in intervention - surgery to treat cardiovascular diseases. After performing aortic replacement surgery, the implementation of abdominal aortic stent graft intervention technique has created conditions for patients to choose optimal treatment methods for aortic diseases. In the coming time, the Cardiovascular Center will continue to deploy new techniques in Cardiovascular Intervention - Surgery to further improve the quality of examination and treatment of cardiovascular diseases for the people of Nghe An as well as in the region.
