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Custom Vascular Care

Most aneurysms can be fixed fairly easily from inside the vessel by implanting a stent graft. The problem comes when a conventional stent would block the flow to branching arteries, such as on the abdominal aorta near the kidneys.

Luis Sanchez, MD, Washington University vascular surgeon, and Gregorio Sicard, MD, the Eugene M. Bricker Professor of Surgery and professor of radiology, executive vice chairman of the Department of Surgery and chief of the vascular surgery section, are working with 10 other centers nationwide to test a new custom fenestrated stent in a clinical trial. “Without the new devices, the only option for these patients has been to repair them from the outside during abdominal surgery, a riskier approach because of the seriousness of the procedure and having to navigate around blood vessels and other sensitive structures,” Sanchez says.

With the fenestrated device, the aneurysm can be repaired from the inside through a small incision in the groin, even when the renal arteries are involved. “We do a three-dimensional CT scan and make careful measurements as to where to place the holes in the stent to line up with the two renal arteries and other branches. Custom devices are manufactured for each patient in the current trials.” Sanchez says.

Fenestrated Stents for AAA

Previously, open procedures were the surgical alternative for abdominal aortic aneursym, but a newly approved procedure called endovascular fenestrated stenting offers patients a less-invasive alternative. Find out more in this podcast with Luis Sanchez, MD, chief of vascular surgery at the Washington University and Barnes-Jewish Heart & Vascular Center.

 
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