By Laura Freeman

If there is a medical situation that compares to feeling like you’re living under the sword of Damocles, finding that you have an aortic aneurysm is one of them.

“An aneurysm diagnosis naturally brings with it a sense of urgency. No one wants to live under constant, life threatening danger. However, in managing the condition and hopefully correcting it, there are situations where patience is a priority,” said Adam Beck, MD, Director of UAB’s Division of Vascular Surgery & Endovascular Therapy.

Beck is also a member of the UAB Cardiovascular Institute. In November he was first in the United States and second in the world to use the new LumiGuide, a second generation 3D device guidance solution powered by Fiber Optic RealShape Technology (FORS).

“The light technology reduces procedure time and the need for fluoroscopy. We are no longer limited to relying on just x-ray or ultrasound for complex visualization of internal arterial anatomies. It allows us to see in real time what’s going on inside what can be very complex and irregular structures. This helps us stay on the cutting edge of endovascular aortic repairs.”

Perhaps the most difficult skill in managing these vascular anomalies effectively is learning how to recognize when it’s better to do something and when it’s better to do nothing. Being able to see what’s happening inside the artery should help.

“Most aneurysms have an annual risk of rupture of around five percent,” Beck said. “If repair has a higher risk, your chance for a good outcome may be better if you do nothing to the aneurysm itself, but instead work on keeping hypertension, weight and other co-morbidities under control.

“You have to bear in mind that risks are cumulative and change over time. With aging and additional illnesses, eventually it may be time for surgery.

“In November, what began as a remarkable first-use scenario for the U.S. allowed us to navigate an aortic aneurysm repair using this incredible new tool. It was so successful we’re now using it to do several procedures a week. UAB is rapidly becoming a regional referral center for repairs like these. As we continue to progress in developing tools and expertise to repair these types of vascular problems, we’re hoping that instead of fear, more people will be able to look forward a long, healthy life.”

The aorta is one of largest and most important great vessels in the body. It is critical to carrying the blood flow that nourishes so many essential body functions. From the heart, the aorta curves upward and branches to supply the brain. It extends downward to bring oxygen and nutrients to the organs of the torso. From there, it divides into the major arteries of the legs and feet, making movement and human activity possible. Unfortunately, although the body depends on this vascular powerhouse for so many of the key functions in life, it doesn’t always supply the quality of materials and perfection in workmanship to sustain it.

“The areas where we are most likely to find trouble are often in the torso near the kidneys,” Beck said. “It may be a malformation or flaw first noticed in early childhood, or a weakness that looks like a balloon blown up too many times that may show up in aging. We are still seeing far too many aneurysms, but with major advances like this, we are headed in the right direction for dealing with them.”