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Minimally Invasive Repair of Abdominal Aneurysms Comes to South Nassau

Until recently, an aortic aneurysm, a dangerous bulge in the wall of the aorta, could only be repaired with traditional open surgery which involves making a large incision in the abdomen. Vascular surgeons at South Nassau Communities Hospital are using a new minimally invasive procedure that eliminates the need for the larger incision.

The procedure, called endovascular abdominal aortic aneurysm repair (EVAR), uses a device called a stent-graft, a wire mesh supporting a fabric tube that is threaded into position through catheters inserted into blood vessels in the groin. The graft is placed inside the bulging area of the aorta to create a new pathway for blood flow, relieving the pressure on the patient’s aneurysm and nearly eliminating the risk of rupture.

“The open surgical procedure, while safe, is one of the most invasive procedures performed on surgical patients,” said Jeffrey S. Stein, M.D., FACS, board-certified vascular surgeon and director of South Nassau’s vascular lab. “The endovascular technique is a safe and effective alternative that also reduces the length of stay in the hospital and post-operative recovery.”

Endovascular repair of abdominal aortic aneurysms involves making a relatively small incision in the area of both sides of the groin, similar to the incision for hernia surgery. The endovascular stent-graft is placed through a small opening in the femoral artery and brought into position using wires and catheters. The stent graft is opened, or “deployed” in the proper position using fluoroscopic guidance. “Recovery is much more rapid with the minimally invasive method,” Dr. Stein said. “Patients usually go home the day after the procedure.” Most patients return to normal activity in 1-2 weeks, as opposed to the open procedure, which requires a 7-10 day hospital stay and several months before a return to normal activity.

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