A Stent in Time – Stenting through a pinhole procedure

Timely detection and swift intervention can prevent strokes, kidney failure and heart disease.

When Mr. Dayal began experiencing back pain and breathlessness at the age of 50, he thought it was a consequence of aging. As none of the conventional balms and muscle relaxants helped, he finally approached our hospital for investigation. And, just as well. Out tests revealed that Mr. Dayal actually had an aneurysm of his aorta involving the entire chest. He also had chronic pulmonary disease in his lungs, which caused the breathlessness.

What are aneurysms?

Aortic aneurysms are abnormal dilatations (bulges) of the aortic blood vessel, which carry blood to the body. The bulge can occur either in the chest or in the abdomen. As the aneurysm expands in size they cause discomfort to the patient in the form of vague chest /abdominal/back pain. Aneurysms can be critical if they burst. This results in heavy bleeding into the chest and abdomen. In fact patients with a ruptured aneurysm have a poor chance of survival. Many of them die before they reach the hospital!

Aneurysms can be fatal

Traditionally such aneurysms are treated by open surgery where the cardiothoracic surgeon opens the chest or abdomen and replaces the diseased aorta with a new graft. Open surgeries have their own problems and require a long hospital stay and may not be possible in very old patients or high-risk patients. In Mr. Dayal’s case major surgery was ruled out because of his bad lung disease.

Now, an option to open surgery

Instead, Mr. Dayal benefited from a new procedure. Instead of an open surgery of the chest, a pinhole-sized incision was made in the groin and through it, an endovascular graft was placed within the aneurysm. This graft prevents any blood flow into the aneurysm and it becomes thrombosed. Mr. Dayal recovered immediately and was discharged without any problems in 4 days. Stents – the new lifesavers Stent grafts like the one used on Mr. Dayal are now commercially available for treatment of aneurysm in the chest and abdomen.

Stenting through a pinhole procedure involves teamwork between the Interventional Radiologist, Cardiovascular Surgeon, Anaesthetist and Cardiologists. The procedure is done under anaesthesia in the Cath Lab. Once the graft is successfully deployed, check angiograms are done. The incisions are closed and patient is monitored in intensive care unit for 24 hours. Because it is a very minimally invasive procedure, patients recover fast and are fit for discharge and are back to routine activities within one week.