Ongoing trials are testing a novel approach to preventing endoleaks (residual bleeding) that affect up to 20 percent of all patients who undergo endovascular aneurysm repair.
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A relatively common problem following this type of repair, endoleaks can require repeat procedures. A stent combined with an inflatable endobag could eliminate the need for repeat surgery and long-term follow-ups as well.
Vascular surgeon Lee Kirksey, MD, says, “The idea is that this technology will effectively obliterate the aneurysm cavity and thus reduce the chance for stent migration and residual leaking into the aneurysm, following endovascular aneurysm repair.”
Aneurysms and repair procedures
Aneurysms are weakened sections of arteries that bulge or balloon out and that can tear or cause dangerous bleeding. Endovascular aneurysm repair is a minimally invasive procedure in which doctors thread a catheter via a small incision, up through the blood vessel to the location of the bulge. Then they deploy a stent (scaffold).
The stent acts as a sleeve, directing blood flow along the length of the section of the artery that has the aneurysm and relieving pressure of blood flow against the weakened artery walls.
Residual issues after procedures
Up to 20 percent of all patients who have an endovascular aneurysm repair need repeat procedures because of persistent entry of blood into the aneurysm sac or bulge. These are called endoleaks.
Endoleaks can occur when stents placed during minimally invasive procedures to repair aneurysms move downward due to the forceful flow of blood and allowing blood to flow into the bulges and weak spots of the aneurysm.
Endoleaks can also occur when blood vessels within the aneurysm pocket or bulge empty blood into the space.
Trials focus on solving endoleak problems
Trials focus on a hybrid type of stent that also delivers an inflatable bag. Once released, the bag fills the cavity of the aneurysm, or bulge, sealing it off permanently.
Cleveland Clinic’s Heart and Vascular Institute is one of two Ohio-based medical facilities currently engaged in the endovascular sealing-repair trials. These studies test the safety and performance of sealing endovascular repair technology.
The trials are intended to determine if using this device in endovascular repair might reduce the incidence of endoleaks and thus avoid the need for repeat procedures, device removal and long-term MRI screenings.