A surgeon at UW Health recently installed a branched stent graft to treat an iliac aneurysm through a minimally invasive operation that required only two small puncture wounds. This was the first such operation in Wisconsin and one of the first in the nation after the device approval by the FDA.
“The surgeons at UW Health are focused on providing minimally invasive procedures to treat vascular disease whenever possible,” says Dai Yamanouchi, MD, PhD, the UW vascular surgeon who performed the operation. “However, iliac aneurysms are one condition that previously could not be easily treated through endovascular therapy. The introduction of this new device changes that. We can now offer patients a solid treatment option for this condition. It’s truly state-of-the-art care.”
The stent used in this procedure — the GORE® EXCLUDER® Iliac Branch Endoprosthesis (IBE) — was approved by the FDA in March and became available for use on April 11. Four days later, Yamanouchi was installing the device in a patient at University Hospital.
“We were able to put this device into use so quickly after availability because our hospital was one of the clinical trial sites for the GORE IBE,” Yamanouchi explains. “Our surgical team became familiar with the device and its use during the clinical trial stage. We were immediately ready to offer it to patients once it was commercially available.”
This is the first device approved to treat iliac or aortoiliac aneurysms. Previously this condition could only be treated through the outside indication usage of the stent graft designed for the aortic aneurysm, or through open surgery, which requires a major incision, blood transfusion, week-long hospital stay, and lengthy recovery time. And not all patients are healthy enough to undergo an open surgery. Yamanouchi’s patient was in surgery for about an hour and went home the following day.
The typical operation is performed through two puncture wounds less than a quarter of an inch wide, through which a surgeon installs a stent graft inside the patient’s iliac artery. The stent reestablishes proper blood flow to the pelvic region.
Iliac arteries stem from the aortic artery that runs the length of the torso to deliver blood from the heart to the rest of the body. The iliac arteries break off in the pelvic region to deliver blood to each leg. Patients who suffer from iliac artery aneurysm often experience numbness in the buttocks, pelvic flow disruption, sexual dysfunction, and digestive pain or colon damage. Left untreated, an aneurysm can lead to further arterial damage, spur blot clots, or burst — all life-threatening situations.
Iliac artery aneurysm is often associated with abdominal aortic aneurysm (AAA), one of the top 20 leading causes of death in the United States. The risk factors for iliac aneurysm include being over 60 years of age and male with a history of smoking, high cholesterol and high blood pressure.