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Featuring Christopher Abularrage, MD, Assistant Professor of Surgery
My name is Chris Abularrage, I’m a vascular surgeon at the Johns Hopkins Hospital.
Endovascular surgery is a minimally invasive technique by which we repair aortic aneurysms of the thoracic and abdominal aorta. This typically entails two small incisions in the groin, through which we place a stent excluding the aneurysm from blood flow from the heart. This results in a shorter post-operative stay and a shorter recovery time.
In order to undergo the minimally invasive procedure, patients need suitable anatomy for the stent graft itself. Patients who do not have adequate anatomy, or those patients who are younger, usually undergo an open repair.
For those patients who are not a candidate for endovascular repair but who either have inhibited risks for open surgery or just not prefer to undergo an open surgery, hybrid procedures can be performed. This can entail placing covered stents into the kidney arteries and then extending the endograft up to cover the kidney arteries themselves.
After minimally invasive endovascular surgery, patients can expect to stay in the hospital on average two to three days and go back to their normal quality of life by two weeks. Long term patients are followed with ultrasounds and CAT scans to make sure that the aneurysms are completely treated.
The most common complication after the minimally invasive endovascular repair is an endoleak. This means a leakage of blood around the graft such that the aneurysm is not completely treated. The good news is that the majority of these leaks can be treated in a minimally invasive manner with percutaneous catheters and devices.
The most rewarding thing that I do is being able to treat patients that are high risk, or otherwise not candidates for open repair, with minimally invasive procedures.
One of the best things about Johns Hopkins is that all of our vascular surgeons are trained in both open and endovascular surgery. Thus, we can provide all patients with the options that are best for them.