Dr. Chiranjiv Virk, a vascular surgeon at Ochsner LSU Health in Shreveport, has successfully performed Louisiana’s first Gore Excluder TAMBE (thoracoabdominal branch endoprosthesis) procedure. This marks a significant advancement in the treatment of aortic aneurysms, offering a less invasive alternative to traditional open surgery.
The Gore Excluder TAMBE device, recently approved by the FDA, employs an endovascular approach using established imaging techniques to deploy the device and seal off the aneurysm, allowing blood to flow directly through the endoprosthesis. This technology had primarily been used in larger city hospitals before Dr. Virk's pioneering use in Shreveport.
Device Functionality and Benefits
According to Dr. Virk, the device is designed with four branches that are deployed in the aorta, enabling a complete repair of the aorta after an aneurysm has occurred. He noted that prior to this device, stent valves were the best option for most patients, but they can be difficult to fit due to variations in patient anatomy. The Gore device offers improved protection for blood vessels leading to the kidneys and intestines.
Aortic Aneurysms: Risks and Traditional Treatments
An aortic aneurysm involves the weakening of the wall of the aorta, the body's main artery. If untreated, it can rupture, leading to potentially fatal consequences. Risk factors include smoking, family history, hypertension, and certain genetic disorders. Due to the often asymptomatic development of aneurysms, regular screenings are recommended for high-risk patients.
Traditional open surgery to repair aortic aneurysms involves a large incision and carries significant risks, including kidney failure, loss of blood flow to the intestines, stroke, paralysis, heart attack, and even death. The Gore device allows for a minimally invasive approach, reducing these risks.
Minimally Invasive Procedure
Dr. Virk explained that the procedure involves small groin incisions and one incision in the right armpit. This less invasive approach generally results in a shorter hospital stay, reduced blood loss, and a faster recovery time for the patient.
Preparation and Follow-Up
Prior to the procedure, Dr. Virk's team spent several weeks preparing, including detailed reviews of CT scans and the use of software to design individualized stent grafts. The CT scans were also sent to the device manufacturer for double-checking measurements. The patient underwent extensive evaluation by the anesthesia team to ensure suitability for general anesthesia.
Three months post-operation, the patient is recovering well. Regular CT scans show the aortic aneurysm is well-sealed, and all aortic branches remain open with good blood flow. Dr. Virk anticipates using the Gore device on other patients at Ochsner LSU Health in the future and is planning a second, more complex case.
Future Implications
Dr. Virk emphasized the significance of bringing this technology to Shreveport, offering patients a new option for treating aortic aneurysms. The Division of Vascular and Endovascular Surgery at Ochsner LSU Health manages and treats various conditions affecting blood vessels, including aortic dissections, blood clots, and varicose veins.
