Customized graft repair saves aneurysm patients from open surgery

A newly approved graft, which is customized for individual patients suffering from abdominal aortic aneurysm using CT models, can provide an alternative to open surgery for some patients.

On Jan. 11, Johns Hopkins Hospital in Baltimore became the first hospital in the mid-Atlantic to use the technique, according to a release from the hospital.

An abdominal aortic aneurysm can become life-threatening if it grows large enough to rupture, with less than a 10 percent chance of survival after rupture. Ideally, a synthetic graft attached via a minimally invasive endovascular procedure can prevent this from happening.

However, up to 30 percent of patients with identified aneurysms cannot undergo the endovascular repair because their aneurysm is located too close to the renal arteries. These patients must undergo a more invasive open surgery.

The new grafts—approved by the FDA in April 2012—have two tiny holes, called fenestrations, fabricated in them to accommodate the renal arteries. Planning for the procedure involves making a 3D image of the patient’s aorta using CT, and sculpting the graft to match the anatomy, according to Johns Hopkins Hospital.

Fabrication of the graft takes about five weeks, but recovery time for the patient post-surgery is reduced. With endovascular repairs, patients can return home after three days and resume normal activity in two weeks, compared with a four- to eight-week recovery following open surgery, according to the hospital.