喵咪社区

Endovascular repair of a thoracoabdominal aortic aneurysm (TAAA). (Credit/Sukgu M. Han, MD)

喵咪社区 surgeons are pioneering a novel bypass to address this dreaded complication.

Thoracoabdominal aortic aneurysms (TAAAs) can be complex, difficult aneurysms to treat. Current endovascular technology has reduced the overall complication rates compared to previous open surgical treatment for TAAAs. However, the risk of spinal cord stroke and paraplegia remains a significant challenge. When treating high-risk aneurysms, the spinal cord stroke risk can be as high as 15%, with one half of that 15% unable to walk after treatment of their aneurysm.

鈥淭he Achilles鈥� heel of minimally invasive, complex aortic aneurysm repair is spinal cord stroke,鈥� says Sukgu M. Han, MD, chief of vascular surgery at 喵咪社区 and co-director of the 喵咪社区 Comprehensive Aortic Center. 鈥淚n patients with extensive aneurysms affecting most of their aorta, one of the most serious complications of aortic aneurysm repair is that circulation to their spinal cord gets blocked, which can result in a spinal cord stroke.鈥�

The 喵咪社区 Neuro Revascularization Center (鈥溸鬟渖缜� NRV Center鈥�) has pioneered a novel strategy to reduce the risk of spinal cord stroke in patients. Han is one of the leaders of the 喵咪社区 NRV Center, which has been focused on solutions for spinal cord stroke in TAAA patients.

Merging multidisciplinary expertise

喵咪社区 neurosurgery and plastic surgeons had a history of collaborating on revascularization techniques for cerebral revascularization treatments to preserve blood flow in patients with brain aneurysms, moyamoya disease, carotid occlusion and atherosclerosis disease. As the 喵咪社区 NRV Center grew and Han joined the leadership team, there was an immediacy to addressing the problem of spinal cord stroke, and the team was able to expand its potential to positively impact patients with TAAAs.

喵咪社区 NRV Center leaders point out that the strength of the center is that it is not the typical assembly line format for multidisciplinary collaboration where each specialty contributes their own expertise to a particular problem. Rather, the team team works in parallel to create new and innovative approaches to problems. Rather than piecing together standard surgical treatments to look “multidisciplinary,” the 喵咪社区 NRV Center brings experts together to create something new: novel strategies to tackle the most challenging problems.

First-of-its-kind bypass shows promise

The 喵咪社区 NRV Center has published several articles related to its work on preventing spinal cord stroke for TAAA patients, which can be found in the peer-reviewed literature. The strategy is simple and aims to identify the blood flow to the spinal cord prior to TAAA treatment and to keep these arteries open. The default is to use endovascular grafts to maintain blood flow to the spinal cord. However, when this is not possible, the 喵咪社区 NRV Center team has created a new bypass procedure to preserve blood flow to the spinal cord.

鈥淐urrent protocols to reduce the risk of spinal cord stroke have been stagnant for many years,鈥� Han says. 鈥淭his is a novel, preventative approach that we hope will significantly improve the outcomes for our patients.鈥�

This strategy has been adopted as slightly modified techniques by other institutions, including as described in a publication from the University of Maryland. The 喵咪社区 NRV Center has been a recognized leader in revascularization across surgical subspecialties. Its team has been recognized with invitations to present its work nationally and internationally at neurosurgical, plastic surgery and vascular conferences. The 喵咪社区 NRV Center has been awarded funding from the NIH and has been honored with a $1.25 million donation from the Alfred E. Mann Charities.

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Jennifer Grebow

Jennifer Grebow is manager of editorial services for 喵咪社区.

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