MedUni Vienna: Neue passgenaue Aortenprothese erstmals in Österreich eingesetzt

Neue Therapieoption ermöglicht nun auch Patient:innen mit einem komplexen Aortenaneurysma eine schonende endovaskuläre Behandlung.

A new type of aortic prosthesis was implanted for the first time in Austria at the Division of Vascular Surgery, Department of General Surgery and the Division of Cardiovascular and Interventional Radiology, Department of Biomedical Imaging and Image-guided Therapy of the University Hospital Vienna and MedUni Vienna. The prosthesis was made especially for a 62-year-old patient with a 5.5 cm abdominal aortic aneurysm. As the aneurysm had already extended to the renal arteries, it was not possible to use a conventional stent graft. Now, the new therapy option also enables patients with a complex aortic aneurysm to undergo gentle endovascular treatment.

Aortic aneurysms can occur in different sections of the aorta, which carries blood from the heart to all other organs. While some aneurysms display no symptoms, larger bulges can cause serious complications, such as ruptures or thrombosis. Aneurysms are particularly common in the abdominal aorta. This was also the case with the patient who was implanted with a new type of aortic aneurysm prosthesis for the first time in Austria in March 2023.

"In the case of larger aortic aneurysms in the abdominal cavity, a so-called Y-prosthesis usually has to be implanted via the inguinal artery under general anaesthesia. The new prosthesis could be implanted purely percutaneously, i.e. without exposing the inguinal artery. The patient could thus be discharged very quickly. The first CT image showed an excellent result," says Florian Wolf from the Division of Cardiovascular and Interventional Radiology (Head: Christian Loewe), Department of Biomedical Imaging and Image-guided Therapy, who performed the operation together with Wolf Eilenberg from Division of Vascular Surgery (Head: Christoph Neumayer), Department of General Surgery.

The special feature of this new type of stent graft is that several windows for the renal and visceral arteries can be sewn flexibly into the prosthesis. The area of the total of five windows reveals only a few metal struts, so that the visibility of the wires and catheters during implantation is facilitated, in contrast to other products. The procedure can thus be performed more quickly and easily. "This new structure of the stent graft allows almost every patient with a complex aortic aneurysm to be treated endovascular," report Florian Wolf and Wolf Eilenberg.

The interdisciplinary aortic centre at University Hospital Vienna and MedUni Vienna has developed into one of the largest aortic centres in Europe in recent years, performing around one hundred procedures for complex abdominal aortic prostheses per year. The high number of cases has a positive effect on expertise and thus on patient safety. Whereas a few years ago complex procedures often took more than six hours, the average procedure time has been reduced to approx.. two hours. Patients with aortic aneurysms are treated around the clock in close interdisciplinary cooperation between the Division of Vascular Surgery, Department of Cardiac Surgery, Division of Cardiac Thoracic Vascular Anaesthesia and Intensive Care Medicine and Division of Cardiovascular and Interventional Radiology; the majority of patients with complex abdominal, thoracic or thoracoabdominal aortic aneurysms can be treated gently using minimally invasive techniques.

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