Vascular surgeons at Manchester Royal Infirmary (MRI) have carried out the first four operations in the UK to repair abdominal aortic aneurysms using a new stent device, designed to enable a much broader group of patients to benefit from minimally invasive surgery.
The four MRI patients – three men and a woman – had their operations in May and early June and all are recovering well. The pioneering surgery was carried out by Mr Ferdinand Serracino-Inglott and his team, using the new Ovation abdominal stent graft system made by US company TriVascular Inc.
An aortic aneurysm occurs when the aorta, the largest artery which runs through the body, balloons or widens. The aneurysm weakens the wall of the artery and can lead to it rupturing, with potentially fatal consequences. A stent is used to allow blood to by-pass the aneurysm. This is known as endovascular aortic repair (EVAR).
EVAR involves making a small cut in the skin of the groin and then guiding a stent up the artery and into position. For some patients with narrow arteries or other complications, there is a risk of damaging the arteries when using traditional stents which are around 8mm in diameter. The new Ovation stent is the smallest ever developed, at only 4-5mm in diameter, making it much easier and safer to manoeuvre through the artery and into position. It is then inflated, and contains a polymer which expands to fit the artery walls, creating a very effective seal. The procedure usually takes less than an hour.
“Our team was delighted to be the first in the UK to trial this new device, and we believe there will be major benefits for patients,” said Mr Serracino-Inglott. “It is a much simpler and less traumatic procedure for the patient, can be done with a spinal epidural rather than general anaesthetic and just involves an overnight stay in hospital. There are fewer risks of damage to the artery, and only a small nick in the skin is required to insert the stent, so recovery is extremely quick. All these factors mean that the option of EVAR will be available to many more patients for whom surgery with standard-sized stents may be too risky.”
He added: “Manchester is a major UK centre of excellence for vascular surgery, and we treat around 120 patients with aneurysms every year. Our team is keen to work with companies like TriVascular, and to help achieve major breakthroughs in surgery for this potentially life-threatening condition.”
The MRI will be one of three UK centres taking part in a pan-European evaluation of the Ovation device, involving 500 patients. The study begins later this month, and is led by Professor Matt Thompson at St George’s Vascular Institute in London. Patients will be followed up after one, six and 12 months, then annually for the next four years. The MRI team is supported by the National Institute for Health Research Manchester Biomedical Research Centre.