Aortic aneurysm, how complex is it? - Michael's story
75-year-old Michael from Yorkshire received a reminder from his GP that people over 65 should undergo routine screening for aneurysms. "I didn’t really pay attention to it at first," he remembers, "because I was already ten years past the age they said you should start. I also didn’t have any worries or concerns about my health."
Michael had an active lifestyle and was fit and healthy. He played golf twice a week, walked his dogs up to three miles every day and enjoyed taking long strolls in the park. He didn’t have any symptoms to suggest he had an aneurysm. "I might not have gone for the screening at all, except there happened to be a testing centre near my driving range, so I figured 'why not?' "
"That 'why not?' question probably saved my life."
Aortic aneurysm – how complex is it?
Michael’s screening results came back as a shock. "I had my scans and they found that I had a particularly complex condition. I had two aneurysms which were at risk of rupturing. One of them was a large one at the top of my stomach, near my chest, and another one was lower down, near the bottom of my stomach."
After speaking to a vascular surgeon at his local hospital, Michael was advised that one way to fix his condition, and the cardiologist’s preferred treatment for him, was open aortic aneurysm surgery. "They said it was very complex because of the location of my aneurysm in the aorta – they were very close to a lot of my arteries."
Michael went through the benefits and risks of an open procedure with his vascular surgeon, and eventually decided it wasn’t the right approach for him. The vascular surgeon recommended a colleague of his, another vascular surgeon, who could perform a keyhole procedure. Keyhole procedures are minimally invasive and so the benefits and risks are different. With a keyhole procedure it wouldn’t be an open surgery, but Michael would need yearly CT scans to make sure his aneurysm didn’t come back. For Michael, that was his preferred option.
Endovascular aneurysm repair (EVAR)
Michael was referred to Mr Said Abisi, Consultant Vascular and Endovascular Surgeon at London Bridge Hospital, by his insurer and by his vascular surgeon. He took that as a sign he was going to the right place. Mr Abisi specialises in EVAR and has a particular interest in new minimally invasive techniques to treat more complex aortic aneurysms, so Michael felt confident he would be able to help him. As a pioneer in the modern treatment of complex aortic aneurysm, Mr Abisi treats patients referred from different parts of the UK and internationally.
"Aortic aneurysm is more common that you think, but most people are unaware that they are living with this condition as there are no obvious symptoms. If an aneurysm ruptures, it causes internal bleeding and is life threatening. It’s important to see a specialist as soon as possible to stop it getting bigger or rupturing (bursting)" Mr Abisi highlighted.
He added: "Prior to the consultation, we have evaluated Michael’s scans and designed a 3D bespoke graft (stent) with side branches to reline his aortic aneurysm, which preserves the blood supply to the kidneys, bowels and pelvic muscles. We were able to insert this graft into his blood vessel through a small incision, avoiding the need for open surgery. The procedure was quick and minimally invasive – next day after his surgery he was already up and walking around."
A surreal experience
Michael and his wife prepared for a trip to London to see Mr Abisi. "I had my surgery on Friday and I was discharged on Monday. The speed of it has just been so surreal. The care was brilliant – I just can’t get my mind around what they do" says Michael.
"I didn’t have any stitches and the physiotherapists came in as soon as I was out of ICU. They had me walking around the wards the next day. The hospital was a great place to recover – the nurses, the physios, they all took great care of me. And the view over the River Thames certainly made me feel better.
Mr Abisi and his team were incredible. I was nervous about the procedure, but they explained everything to me and they were so calm and confident – which made me feel very comfortable. It was just like an everyday job for Mr Abisi and that put me at ease knowing I was in such safe hands.
I strongly advise everyone to go for a screening when they’re eligible. I never would have thought of having a test. I didn’t have any symptoms, but the screening identified the aneurysm before it burst, so it saved my life."