Aneurysm:

An aneurysm is an abnormal widening
or ballooning of a portion of an artery
due to weakness in the wall of the
blood vessel.
EVAR  stands for Endovascular
Aneurysm Repair (or Endovascular
Aortic Repair), is a type of
Endovascular surgery used to treat an
abdominal aortic aneurysm.



FDA APPROVES APTUS
ENDOSTAPLING SYSTEM TO REPAIR
FAILING  AORTIC ENDOGRAFTS
In November 2011 the FDA allowed
marketing of the first system that can
repair a failed or problematic aortic
endograft, a fabric tube used to repair
a dangerously large aortic aneurysm,
a bulge in the large blood vessel that
carries blood away from the heart.

The innovative helical anchor
technology enables independent
endograft fixation, and is designed to
mimic the hand suturing performed
during open surgical repair of
abdominal aortic aneurysms (AAA).

Aortic aneurysms are an enlarged and
weakened section of the aorta, the
main artery carrying blood from the
heart, which can be lethal if left
untreated. Each year, an estimated
200,000 people in the U.S. and
100,000 people in Europe are
diagnosed with AAA. In EVAR, an
alternative to open surgical repair of
AAA, a minimally invasive catheter-
based system is used to implant a
metal and fabric endograft to isolate
blood flow away from the aneurysm to
prevent potential rupture and death.

Aortic aneurysms can, over time,
become weak and result in a life-
threatening rupture. The endograft is
placed inside the aorta to seal off the
aneurysm and direct blood away from
it.

The HeliFX System provides
physicians with a novel technology to
repair endovascular grafts that have
migrated away from the implant site,
have developed endoleaks or are at
risk of developing these complications,
which are commonly seen after EVAR.
In such cases, augmented fixation
and/or sealing is required to regain or
maintain effective aneurysm exclusion.
The system also can be used during
the initial EVAR procedures to
enhance an endograft's inherent
fixation and sealing mechanisms.

The Aptus EndoStapling system is a
cassette of nickel-cobalt corkscrew-
shaped staples that is loaded into a
long, thin, tube-like delivery catheter.
The catheter is inserted into an artery
in the leg and directed through the
arteries to the failed endograft. Using a
controller on the handle of the
catheter, the surgeon applies one
staple at a time around the top edge of
the endograft to anchor the device and
repair the endograft-artery seal.

This approval is  based on a review of
data from 154 patients who were
implanted with 810 EndoStaples.
Patients were monitored with routine
followup CT scans. After a year, none
of the EndoStaples had fractured and
no patients experienced endograft
movement (migration); one subject
needed an additional intervention to
address an endoleak.

The Aptus EndoStapling System is
manufactured by Aptus Endosystems
Inc. of Sunnyvale, Calif.




FDA APPROVES STENTS TO REPAIR
ABDOMINAL ANEURYSMS IN PEOPLE
WITH SMALL ARTERIES
In November 2011 the FDA  has
approved a stent graft system that
provides patients with small arteries
the option of less invasive surgery to
repair their potentially life-threatening
abdominal aortic aneurysm.

An abdominal aortic aneurysm is a
bulge in the part of the aorta that runs
through the abdomen and divides into
the arteries that supply blood to each
leg. Over time, this bulge can become
weak, and the force of normal blood
pressure can cause it to rupture, which
can be life-threatening.

Aneurysms can be repaired through
open surgery or less invasively with
endograft repair using a stent graft
otherwise known as an endograft.

Endografts feature a tube typically
made of plastic material that is
supported by a metal frame or stent.
They are compressed into a delivery
catheter, inserted into the femoral
artery of the leg and then threaded
into position in the weakened portion
of the artery where they are released.
Once released, the endograft expands
against the wall of the aorta to redirect
blood flow away from the aneurysm.

Treatment with a stent graft depends
on the patient’s anatomy. A small
number of people have blood vessels
that are too small in diameter to
accommodate typical endograft
systems on the market.

Manufacturer: TriVascular Inc. os
Santa Rosa, California



COIL OF WIRE FROM EV3
The Food & Drug Administration
granted ev3 Inc. an expedited review
of the pre-market approval application
the company filed for its Pipeline
cerebral aneurysm treatment.
The device is designed to treat large,
giant and wide-necked brain
aneurysms.
The device is a coil of wire delivered to
brain aneurysms via catheter,
designed to encourage blood to clot
around them to relieve pressure.
Aneurysms involve weak portions of
blood vessel walls, which puch out
from the pressure within the vessel
and are at risk of bursting.
Ev3 said a 108-patient clinical trial of
the device is examining its suitability
for treating large aneurysms that aren't
typically coiled.
In July 2010, ev3 Inc. became a part of
Covidien, a leading global healthcare
products company.




EVAR:A MINIMALLY INVASIVE
PROCEDURE
EVAR  stands for Endovascular
Aneurysm Repair (or Endovascular
Aortic Repair), is a type of
Endovascular surgery used to treat an
abdominal aortic aneurysm.
The standard treatment for aortic
aneurysm, open repair, involves a
large abdominal incision and cross-
clamping of the aorta.
In recent years, a minimally invasive
technique,EVAR has been developed:
a graft is placed in the aorta via the
femoral arteries, without an abdominal
incision and with much smaller
changes in cardiovascular blood flow.
Potential advantages over open repair
include reduced morbidity and
mortality, the possibility of operating on
patients unfit for open surgery, and
reduced length of hospital stay.



OVERVIEW

ANEURYSM: THE SILENT
KILLER

It is called the Silent Killer
because it rarely has any
symptoms.

BRAIN ANEURYSM

Platinum wires are a crucial
component of a new technique
for treating cerebral aneurysms
to prevent strokes occurring, it
has been confirmed.


Rockford Health System (RHS)
in the US  is now trialling a
minimally invasive procedure
that stops brain aneurysms
from rupturing, and strokes
from occuring.


Known as cerebral embolization
with coiling, the process
involves threading a micro
catheter from the femoral artery
in the leg up to the brain, with
the help of X-ray guidance.

The catheter is fitted with the
thin platinum wires, which coil
into a ball within the aneurysm
to allow blood to clot around
them, thus reducing the chance
of an aneurysm bursting.

Dr Bratislav Velimirovic, a
neurosurgeon in the Brain and
Spine Center at RHS, who
developed the new procedure,
revealed that it has been test on
about 12 patients already, all of
whom have experienced
quicker recovery times in
comparison with those using
traditional surgery.

The traditional surgery is called  
craniotomy.

The craniotomy is a very
invasive procedure.
In craniotomy part of the skull is
cut away to allow access to the
brain so a tiny metal clip can cut
off blood flow to the aneurysm.
A lot of patients who can't
medically undergo this
procedure  are candidates for
the new one: embolization.

The prevalence of aneurysms in
the U.S. is about 2 percent of the
population.
10 to 15 percent of emergency
patients die before reaching a
hospital and another 50 percent
die within 30 days of a rupture.
Of those who survive,
Velimirovic said, about 50
percent suffer some type of  
neurological deficit.

"We can have a patient on the
operating table in between one
and two hours from the time
they reach us," says the
specialist. "The procedure takes
another one hour to several
hours."

Brain  or cerebral aneurysm
could be discovered during
treatment for a stroke or
following up   a patient's  
complaints  about  unusual
sounds in one ear, increased
pressure in the eyes, double
vision, or headache pain.

The same microcatheter
technology used for the coiling
allows the surgeon to perform
arterial stroke therapy to retrieve
blood clots that cause the
stroke.
In that  procedure the lead wire
takes the catheter to the blood
clot. The lead wire is retracted
and replaced by a snare (a
capturing)  device which is run
through the clot. The snare
hooks onto the clot and the
catheter is used to pull the clot
out of the artery.


ABDOMINAL ANEURYSM
AAA or abdominal aortic
aneurysm is an aneurysm of the
abdominal aorta associated with
old age and hypertension.
Aorta is  the body's largest
blood vessel which runs from
the heart through the abdomen.
AAA can weaken the aorta.
When blood flows through the
aorta, the pressure of the blood
beats against the weakened
wall, which then bulges like a
balloon. If the balloon grows
large enough, there is a danger
that it will burst.
Three out of four patients show
no symptoms. When there are
any,  they may include:
Abdominal pain (that may be
constant or come and go) / Pain
in the lower back that may
radiate to the buttocks, groin or
legs /  The feeling of a
"heartbeat" or pulse in the
abdomen
The goal of therapy for
aneurysms is to prevent them
from rupturing.
Once an abdominal aortic
aneurysm has ruptured, the
chances of survival are low,
with 80 to 90 percent of all
ruptured aneurysms resulting in
death. These deaths can be
avoided if an aneurysm is
detected and treated before it
ruptures.
An estimated 27 million people
worldwide have abdominal
aortic aneurysms.In  the US
alone, approximately 15,000
people die every year due to an
abdominal aortic aneurysm
rupture.
In the past 30 years, the
occurrence of Abdominal Aortic
Aneurysms (AAA) has increased
threefold.
Medicare in the US now pays for
an initial abdominal aortic
aneurysm screening when
patients turn 65 — but only for
certain people. They are
screening men aged 65 to 75
who at some time had a
smoking habit.  Non-smokers
are left out. Women are also left
out.
There is a new study out that
recommends accepting a wider
selection of people.
US retail chain, K mart is now
offering free screening for
eligible men. They are using
ultrasound for testing.
Ultrasound imaging, when
conducted by an expert
technician, is supposed to be
nearly 100% precise.

TREATMENT IF CAUGHT IN
TIME
EVAR or  Endovascular
aneurysm repair is a newer form
of treatment for abdominal
aortic aneurysm that is less
invasive than the traditional
open surgery.
The stent graft is placed inside
of the aortic aneurysm with the
help of a long, thin, plastic
delivery catheter. The delivery
catheter contains the
compressed stent graft.
The endovascular stent graft is
put into place inside the
aneurysm without removing any
tissue from the aorta, and it
does not require to open the
chest  or open the abdomen.
Because of this, the recovery
time faster compared to open
surgery.
The AneuRx AAAdvantage  
Abdominal Stent Graft System
from Medtronic  is the most
implanted AAA stent graft in the
world. This  system has treated
abdominal aortic aneurysms in
over 83,000 patients.
Incraft, from  Cordis Corporation
(a division of Johnson &
Johnson) is trialling a new stent
graft system in 3 locations in
Germany. Incraft's graft is
thinner so that it is eminently
suitable for small or  diseased
access vessels.
Prevention, like with all
illnesses, is critical.
Researchers found that
consuming fruits, vegetables
and nuts, and increasing
exercise regimens decreased a
patient's risk for AAA. But, a
body mass index greater than
25 kg/m2 can boost a patient's
risk of AAA.







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