Clinical Research News

Thoracic Aortic Stent-graft Takes on a Silent Killer

Each year, more than 20,000 Americans are diagnosed with thoracic aortic aneurysms. These aneurysms occur when a section of the aorta running through the chest weakens and bulges outward like a balloon. The aorta is the body's main circulatory vessel. If an aortic aneurysm expands to the point where it ruptures, the resulting internal bleeding is life threatening. Thoracic aortic aneurysms are known as a silent killer since patients typically have no symptoms until the aneurysm begins to leak or expand. Most commonly caused by atherosclerosis (hardening of the arteries), these aneurysms can be detected through a chest X-ray or a chest CT scan. Thoracic aortic aneurysms are repaired by vascular and cardiac surgeons and interventional cardiologists. Cardiac surgeons specializing in these repairs at Columbia include Allan S. Stewart, MD and Mathew R. Williams, MD. In addition, hybrid procedures, incorporating both open and interventional techniques are employed to give patients optimal outcomes.

Vascular surgeon James F. McKinsey, MD, is the principal investigator of a clinical trial focused on a less invasive treatment for patients with thoracic aortic aneurysms. "In the Thoracic Aortic Stent-graft trial we are testing a new, minimally invasive way of repairing these aneurysms without the need for major surgery," says Dr. McKinsey. "In this new endovascular approach, we make small incisions in the groin while the patient is under a local anesthetic. Using those incisions, we guide a catheter through the patient's arteries into position at the aneurysm site. We then secure a two-piece, self-expanding stent-graft inside the weakened section of the thoracic aorta.

Eligibility criteria for the trial include:

• A history of other medical problems, such as heart disease or lung disease
• Adequate fixation sites above and below the aneurysm in the aorta
• Aneurysms greater than 5 cm, penetrating ulcers, or aortic dissections

For more information on the Division of Vascular Surgery, please visit www.nypvascularcare.com. For more information about the Division of Cardiothoracic Surgery, please visit www.columbiaheart.org.