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Minimally Invasive Repair of Ruptured Aortic Aneurysm Could Save More Lives than Surgery
Date:1/18/2010

o did not, all of which were confirmed by CT. All patients with an endoleak had elevated concentrations of MMP-9, compared to only one patient without an endoleak. In that patient, concentrations were only slightly elevated, and researchers determined MMP-9 concentrations of 55.18 or greater can identify endoleaks with both high sensitivity and specificity.

“The study is the first to show that concentrations of MMP-9 might accurately discriminate between patients with and without an endoleak,” said Dr. Ten Bosch, who is presenting the study at ISET. The results must be confirmed by a prospective clinical validation trial, he said.

Endobag May Prevent Leaks

A new type of EVAR device that treats the entire aneurysm – a bag instead of a tube – could solve some of the problems of endografts, including leaking and shifting of the device. It could also be used to minimally invasively treat more people whose blood vessel anatomy isn’t conducive to EVAR with an endograft.

The treatment involves advancing two five- to six-inch stents enclosed in the deflated endobags to the site of the aneurysm, one through the right femoral artery, and one through the left. Each stent is inflated with a balloon (which is then deflated) and provides the scaffold defining the channels through which the blood flows. The endobags are filled with polymer and conform to the available space inside the aneurysm. The polymer cures in approximately five minutes to a consistency similar that of a pencil eraser, creating a durable repair designed not to shift or leak. Essentially, the portion of the aorta with the aneurysm is bypassed with two channels that direct blood to the right and left femoral arteries.

To date, 32 people in four countries (Colombia, Venezuela, Latvia and New Zealand) have had the endobag device implanted. Independent audited results are not yet available.

“The endobag seals the aneurysm, a
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