Janet Murphy had no idea how long she had an abdominal aortic aneurysm.
But as a retired nurse, she knew the weak spot—or enlargement—in the body’s main artery posed serious risks. A rupture could be fatal.
That’s why she welcomed an innovative treatment that repaired the abdominal aortic aneurysm in a minimally invasive procedure.
“It’s wonderful. It’s a tremendous relief,” said Murphy, 81, as she recovered in her Grand Rapids, Michigan, home.
Like many people with an abdominal aortic aneurysm, Murphy learned about hers while seeking treatment for something else.
About five years ago, she underwent a CT scan to check for kidney cancer. She didn’t have cancer, but the urologic oncologist told her the scan revealed a bulging section in the part of the abdominal aorta.
Because the aorta is the main blood supplier for the body, a rupture of an aneurysm can cause life-threatening internal bleeding, said Peter Wong, MD, a Spectrum Health vascular surgeon.
Aortic aneurysms were the primary cause of 9,863 deaths in 2014 and a contributing cause in more than 17,215 deaths in the U.S. in 2009, according to the Centers for Disease Control and Prevention.
Murphy consulted Spectrum Health vascular surgeons, who monitored the aneurysm every six months with ultrasounds.
She continued to enjoy life with her husband, Frank, and spending time with their five children, seven grandchildren and four great grandchildren. They spent summers at their up-north home in Roscommon, near Higgins Lake.
The aneurysm slowly grew. At first, Murphy hoped she would not need surgery. But, as the aneurysm neared 5 centimeters, she said, “I began to think I had a little time bomb going on in there.”
A scan in April showed the aneurysm measured 5.5 centimeters.
“Dr. Wong came in and said, ‘Now we have the surgical conversation,’” she said.
Twenty years ago, abdominal aortic aneurysms were repaired with open abdominal surgery, Dr. Wong said. That typically would require a week-long hospital stay.
Many are now repaired with covered stent grafts placed through an endovascular procedure—working inside the artery. Surgeons access the femoral arteries through tiny punctures in the groin, like the punctures made to start an IV. Patients typically go home from the hospital the next day.
And Murphy was able to undergo the procedure using a newer technology in stent grafts, the Endologix Ovation abdominal stent graft system. It was developed particularly for patients with smaller blood vessels or other anatomical challenges, such as calcification in the arteries.
Ovation may be a better option for many women because of its lower profile for smaller arteries and the ability to treat challenging cases, Dr. Wong said.
The procedure took place on a May morning at Spectrum Health Fred and Lena Meijer Heart Center.
Dr. Wong placed sheaths into the femoral arteries on each side of the groin. Through them, he deployed the stent graft into the abdominal aorta.
Dr. Wong described Janet’s aorta, with its calcifications, as an area filled with nooks and crannies, “like a coral reef.”
The polymer inside the stent, made of a gel-like material, conformed to the uneven wall of the artery. It allowed blood to flow straight through the newly deployed covered stent grafts, diverting it away from the weakened spot created by the aneurysm.
A recent study of the Ovation stent system found it increased access to endovascular treatment for women with abdominal aortic aneurysms by at least 28 percent.
A week after the procedure, Murphy moved slowly, but felt better and looked forward to heading up north for the summer.
“For the next people facing this, I would say there really isn’t a lot to fear,” she said.
Smoking, diabetes, high blood pressure and high cholesterol increase a person’s risk of having an abdominal aortic aneurysm, Dr. Wong said. Having a family member who had an abdominal aortic aneurysm also increases a person’s risk.
He recommends people with the one of these conditions receive ultrasound screenings for an abdominal aortic aneurysm.
In the 50-and-older population, studies show abdominal aortic aneurysms affect 3.9 percent to 7.2 percent of men and between 1 and 1.3 percent of women, according to the U.S. Preventive Services Task Force.