May 22, 2019
Hackensack Meridian Health Hackensack University Medical Center offers patients a new treatment for a potentially fatal cardiovascular condition known as an aortic dissection, in which the inner layer of the aorta, the large blood vessel branching off the heart, tears. Blood surges through the tear, causing the inner and middle layers of the aorta to separate. Following FDA approval, surgeons at the Heart and Vascular Hospital at Hackensack University Medical Center became one of the first hospitals the United States to use Cook Medical’s Zenith Dissection Endovascular System to treat an emergent complicated Type B aortic dissection. This system provides physicians a less invasive alternative to open surgery for such an emergency.
“This new system provides a minimally invasive treatment option for patients with Type B aortic dissection, which is a common, yet potentially fatal cardiovascular emergency,” said Massimo M. Napolitano, M.D., FACS, vice chair, Department of Surgery, director, Vascular Services, Hackensack University Medical Center. “Until now, we were only able to treat these patients with blood pressure control. This new system allows us to actually manage dissections and save lives.”
The system consists of a proximal stent-graft component and a distal bare stent component, which is inserted percutaneously through the groin with no incision.
“The patient was experiencing severe chest, back and abdominal pains and was diagnosed with a complicated Type B aortic dissection,” said Michael Wilderman, M.D., FACS, chief of Endovascular Surgery, Hackensack University Medical Center.
Dr. Wilderman has extensive experience with the Cook Medical device, having been the principal investigator for Hackensack University Medical Center, one of the lead enrollers during the STABLE II pivotal clinical trial. “In addition to the patient’s aortic dissection, he had poor blood flow to his intestinal arteries.”
The patient is 64 year old, Benjamin Candelaria, of East Rutherford, who sought treatment in the Emergency and Trauma Center at Hackensack University Medical Center.
“I had chest, abdominal and back pain and I was really concerned,” recalls Benjamin. “I was pretty apprehensive about having more surgery. But, the doctors explained there was an alternative.”
Ben was taken to the Hybrid Operating Room suite in the Heart and Vascular Hospital at Hackensack University Medical Center, where Dr. Wilderman and his team implanted the Cook Medical Zenith Dissection Endovascular stent. The procedure was performed in an hour and a half. Ben spent three nights in the hospital and was discharged once his blood pressure stabilized.
“As a recognized leader in cardiovascular clinical excellence and research, the Heart and Vascular Hospital embraces new technology to provide patients to the safest and most advanced treatments on the market,” said Joseph E. Parrillo, M.D., chair, Heart and Vascular Hospital. “This new treatment of aortic dissections is a truly revolutionary, lifesaving technology that will improve patient outcomes.”
The aorta is the largest artery of the body, and it receives oxygen-rich blood from the heart and distributes it to the body through smaller arteries. Most aortic dissections occur because high blood pressure causes the artery’s wall to deteriorate. Aortic dissection symptoms may be similar to other cardiovascular conditions and typically include sudden, excruciating pain, most frequently across the chest but also in the back between the shoulder blades. Aortic dissections are three times more common among men and are more common among African-Americans. About three fourths of aortic dissections occur in people aged 40 to 70.
The Zenith system is inserted via a catheter through the femoral artery in the groin and is carefully guided to the location in the aorta where the tear begins. Once in place, the device helps to prevent the aorta from rupturing and can reestablish vital blood supply to other areas of the body. It is less invasive than other treatment options for aortic dissection repair, and offers quicker recovery times for patients. Before it was approved by the FDA, the device underwent two multi-year clinical trials with multiple centers participating around the world, including Hackensack University Medical Center.