Inova Expands Options for Treating Complex Aortic Disease

Inova uses a collaborative approach combining the expertise of different medical specialists with state-of-the-art technologies to offer patients access to leading-edge, less invasive, endovascular treatment options for complex aortic conditions.

Cardiothoracic surgeons, vascular surgeons and interventional radiologists at Inova Heart and Vascular Institute (IHVI) work together to treat complex vascular diseases and conditions. They meet regularly to discuss cases to determine the best course of treatment. Then, they collaborate to perform endovascular procedures, including use of the latest aortic endograft devices, known as stents or grafts, to provide patients with a comprehensive and tailored treatment plan that achieves optimal results.

The team approach is a significant advantage. “We harness the best of our talents, working together to bring patients the most advanced, effective treatments,” said Richard Neville, MD, Chair, Inova Department of Surgery; Director, Inova Vascular Surgery; and Associate Director, IHVI.

L-R: Richard Neville, MD, Dipankar Mukherjee, MD, Kendal Endicott, MD, and David Spinosa, MD

Leading-edge devices

The aorta, the largest artery in the body, transfers oxygen-carrying blood from the heart to the circulatory system. Inova’s aortic disease team has been involved in several pivotal clinical trials to test the most promising aortic repair technologies, including  major trials for a device known as an infrarenal aortic aneurysm graft. These advanced grafts allow treatment of aortic aneurysms below the kidneys while sparing a critical artery that provides blood flow to the organs in the pelvis. The team was also recently invited to participate in a clinical trial to evaluate aortic repair in zone zero, the section of the aorta just beyond the aortic valve and extending to the first branch of the aorta.

“Because of our active research involvement, patients have access to the newest devices and other leading-edge treatments,” said cardiothoracic surgeon Liam Ryan, MD.

In the last year, Inova became one of the first sites in the nation to offer the thoracic branch endograft outside of clinical trials. This endograft is the first such device that allows better positioning within the thoracic branch and more easily allows blood to continue flowing freely to the arm.

The team also treats aneurysms that form in the area inside the chest to the abdomen with graft devices that are threaded through the artery for placement, using custom-made devices based on a patient’s own unique anatomy. Previously, this required major surgery to open the chest and abdomen, place a surgical graft, and reimplant all the critical branches that supply blood to the liver, spleen, intestines and kidneys. However, using this innovative technology, IHVI can offer an effective, minimally invasive treatment to many patients, including those who would not have been able to undergo complex open surgery.

The future of aortic disease care

Using a multidisciplinary team-based approach employing a wide range of endovascular treatments has a direct positive impact on patients. Not only do these techniques offer more treatment options to patients with previously inoperable conditions, but they also significantly improve patient outcomes.

 “At Inova, our commitment to quality ensures that we continually evaluate how we can improve our care and outcomes,” said David Spinosa, MD, Section Chief, Interventional Radiology, Inova Fairfax Medical Campus. “We actively participate in data collection and report our outcomes by sharing our data and results with both regional and national databases.”

Patients who undergo less invasive endovascular treatment typically benefit from shorter lengths of stay and fewer complications such as heart attack or stroke. At Inova, outcomes are on par with or exceed those of other hospitals within the region and nationally.

“Not very far in the future, we believe that endovascular treatments will not only be possible for the entire aorta, but they will be the preferred treatment,” said Inova vascular surgeon Kendal Endicott, MD. “The endovascular industry is booming with opportunity. We’re proud to be poised as an institution to be at the forefront of these opportunities and changes.”

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