Robert Wood Johnson Medical School has become one of the premier centers in New Jersey for the treatment of patients with aneurysms. We treat thoracic aneurysms, thoracoabdominal aneurysms, abdominal aortic aneurysms, iliac artery aneurysms and popliteal aneurysms, which are located in the arteries behind the knees. Our team of highly trained physicians specializes in the treatment of complex thoracic, thoracoabdominal and intra-abdominal aneurysms in both acute and chronic presentations. We offer open surgical repair, but most recently have become a leader in innovative endovascular repairs for patients with complex aneurysms.
Here at Robert Wood Johnson's Aneurysm Center, early identification and treatment of patients with aneurysms prevents ruptures and saves lives.
An aneurysm is an enlargement of a blood vessel that is usually caused by a weakening of the blood vessel wall. Arterial aneurysms can occur in any artery, but most commonly occur in the main artery in the abdomen and chest, the aorta. They can also occur in the arteries in the brain (intracranial or Berry aneurysm) and the legs (popliteal aneurysm). If an aneurysm develops in the aorta in the chest, it is known as a thoracic aneurysm. Aneurysms in the abdomen are called abdominal aortic aneurysms (AAA), and those in both the chest and the abdomen are called thoraco-abdominal aneurysms. Aneurysms are frequently called "the silent killers," as most aneurysms are asymptomatic until they rupture. The potential for aneurysm rupture is greater with increasing aneurysm size. When aneurysms rupture, they cause life-threatening hemorrhage and, potentially, death.
Surgical intervention is necessary to prevent aneurysm rupture. Aneurysm repair is accomplished via both traditional surgical operations and the ever-increasing minimally invasive option called endovascular aneurysm repair (EVAR). Although we have extensive experience and excellent results with both open surgical repair and EVAR, minimally invasive endovascular repair is rapidly becoming the treatment of choice, if possible, for most aneurysms. Robert Wood Johnson University Hospital has become the leader in the field of endovascular aneurysm repair in New Jersey and is the premier institution for the treatment of patients with complex aneurysmal disease. We pride ourselves on developing innovative solutions for complex aneurysms via our multidisciplinary approach.
Abdominal Aortic Aneurysm Repair
Traditional surgical treatment for an abdominal aortic aneurysm (AAA) is performed with general anesthesia and is accomplished with a surgical incision in the abdomen or flank. The aneurysm is opened and replaced with an artificial tube that is sewn in to the normal artery above and below the aneurysm.
Endovascular aneurysm repair (EVAR) is a minimally invasive procedure that is also used in the treatment of abdominal aortic aneurysms. In an EVAR, a manufactured device known as a stent-graft is deployed under X-ray guidance inside the aneurysm to exclude it from the circulation. Several different devices are used for these repairs at the institution, including the Gore Excluder, Cook Zenith and the Medtronic Talent devices. We are experts in selecting the appropriate device for your specific aneurysm. The major advantages of the endovascular repair include avoidance of major abdominal surgery, shorter length of stay, and a much faster recovery. In fact, most patients only stay overnight in the hospital and are back to normal activity within a week.
The number of patients being treated with an endovascular stent graft is growing rapidly each year. At the present time, more than 100 endovascular repairs are performed each year at Robert Wood Johnson University Hospital.
Thoracic Aneurysm Repair
Thoracic aortic aneurysms (TAA) are potentially even more dangerous than abdominal aortic aneurysms, as when they rupture, mortality is extremely high. Traditional surgical repair is done via either an incision directly through the sternum, or an incision in the left chest, depending on the location of the aneurysm. Open surgical repair is sometimes the best and only option, but this approach can only be used for patients who are considered an acceptable surgical risk. This leaves many patients with no acceptable options for a repair.
In March 2005, the U.S. Food and Drug Administration approved the first minimally invasive endovascular device for the treatment of thoracic aneurysms. This device was known as the GORE TAG Thoracic Endoprosthesis. This device was extremely successful and has opened the doors for the development of more thoracic endovascular devices. Repair of thoracic aneurysms at Robert Wood Johnson University Hospital is now performed using either the Gore TAG Thoracic Endoprosthesis or the new Medtronic Talent Thoracic Aortic Graft. Minimally invasive repair of TAAs is usually performed through small incisions in the groin, avoiding the prolonged recovery time and complications from an incision through the chest wall. Minimally invasive repair has allowed us to offer treatment to many patients who were considered too high of a surgical risk for open surgery in the past. There is no doubt that this development has saved lives.
A multidisciplinary approach is used at the hospital, and frequently repairs of thoracic aneurysms require the expertise and combined skills of both our Cardiothoracic Surgical Team and Vascular Surgical Team. Both teams of surgeons are frequently involved with the planning and repair of these aneurysms, in both open surgical repair and endovascular repair. This approach has led to a large clinical experience with this new technology.
Thoraco-Abdominal Aneurysm Repair
The most complex and dangerous of all aneurysms is the thoraco-abdominal aneurysm. A thoraco-abdominal aneurysm is an extensive aneurysm of both the thoracic aorta and the abdominal aorta. Surgical repair can be performed, but carries a high morbidity and mortality. We have gained significant experience in performing hybrid procedures that combine both open surgical techniques and endovascular techniques to provide patients with a lesser invasive treatment option. We will soon have available to us fenestrated endovascular devices that will allow us to address complicated thoracoabdominal aneurysms with even less invasive surgical reconstructions than ever before. At the Aneurysm Center, we offer you the best chance for a successful repair and recovery. Our multidisciplinary team of hand-picked experts includes the best anesthesiologists, surgeons, critical care specialists, nurses and ancillary staff in the region. Our success with treatment of these patients rivals the best centers in the nation.
Special Treatments or Services
State-of-the-art pre-operative imaging
Thoraco-abdominal aneurysm repair
Endovascular stent graft program
Complex abdominal and peripheral aneurysm repair
Outstanding post-procedure multi-disciplinary care
Long-term follow-up
For more information about aneurysms and their treatment, please visit the following websites:
