The benefits of EVAR (Endovascular Aneurysm Repair) procedure for patients in our Community

"I find the great thing in this world is not so much where we stand, as in what direction we are moving" Oliver Wendell Holmes."

Progress is the activity of today and assurance of a better tomorrow. In a medical field, progress and innovation lays the foundation for a better health care system for patients in our Community.

Paving the path to bring in new technologies and skills in the Cardiac arena has always been Dr. Shafiq's greatest interest. With the inclusion of EVAR as an alternative option to open abdominal surgery for the treatment of Abdominal Aortic Aneurysm (AAA), patients in our Community will be receiving a choice in quality care. Dr. Shafiq will soon be providing this alternative and less invasive surgical option to all those patients who are being diagnosed with Abdominal Aortic Aneurysm (AAA) by the introduction of EVAR (Endovascular Aneurysm Repair) procedure at the Cath Lab at Paris Regional Medical Center.

The guests listening to the EVAR Talk at Paris Cardiology Center.

Keeping this innovative procedure in mind and to create awareness for the multiple benefits of EVAR procedure for our patients in our community, Dr. Shafiq hosted a Cardiac talk on EVAR at his clinic Paris Cardiology Center on November the 9th 2012. Several Physicians and Allied Health Professionals in our Community attended this talk.

Dr. Javiar (Jay) Vasquez, J.R. from Surgical Associates of Dallas was invited to present his talk on the Tips, Tricks and Future Trends of this new and innovative EVAR procedure.

Dr. Jay Vasquez is a Vascular Surgeon from Surgical Associates of Dallas. He is a Diplomat of the American Board of Surgery and is Board certified in General Surgery and in Vascular Surgery. He has been chosen by "D Magazine" as one of the "Best Doctors in Dallas". (in it's 2006, 2008, 2009 and 2010 issues).

What is Aortic Aneurysm?

The aorta is the main artery in the body. It runs from the heart, chest and abdomen and supplies branches and blood to all major organs .An aortic aneurysm is a bulge usually in the abdominal aorta.

When the artery wall weakens, it stretches because of the pressure of the blood flowing through the aorta to form an aneurysm. The bigger the aneurysm, the greater is the chance of it's rupturing and if it bursts it can lead to death.

What are the treatment options for Aortic Aneurysm?

There are two treatment options.

Open Abdominal Surgery.
Endovascular Aneurysm Repair (EVAR) using stent graft.

Open Abdominal Surgery.

Once an aortic aneurysm reaches a certain size, the risk of it's bursting increases. If the aneurysm is small, it is kept under check by ultrasound to keep a close eye on its size. If it grows bigger, it is much safer to repair an aneurysm before it ruptures. This is called elective repair. Before the elective repair you will have a CT scan to provide a very detailed picture of the aneurysm. Depending on a number of factors, the shape of the aneurysm and likelihood of complications from EVAR procedure open abdominal surgical repair may be considered as the safest treatment.

EVAR (Endovascular Aneurysm Repair) using stent graft.

		EVAR is a relatively new technique for repairing aortic aneurysms. It has been developed over the past 10 years. A stent graft is a metal meshwork tube covered by the same material that would be used in open abdominal surgical repair. This tube usually divides in two limbs at its lower end, like trouser legs. The stent-graft is inserted into the aorta through the femoral arteries (main arteries to the legs) through two short incisions (cuts), one in each groin. It is then positioned and released across the aneurysm and seals the aneurysm at the top and bottom. This re-lines the aorta from the inside and prevents blood from flowing into the aneurysm and causing further enlargement and rupture.
Picture of (AAA) Stent Graft used in the EVAR Procedure

What are the Pros and Cons of EVAR compared to traditional Abdominal Open Surgical Repair?

EVAR is usually performed under regional or spinal anesthetic sedation while open surgery is performed under general anesthetic.
EVAR is performed through small groin incisions whereas open surgical repair requires a big abdominal incision, which is large and uncomfortable.
After EVAR procedure, hospital stay is usually 2 days. Following open surgical repair you would be admitted to intensive care and your overall stay at the hospital would be 10 days.
There is minimal blood loss during EVAR and no need for blood transfusion. Blood loss in open surgery procedures is common and requires blood transfusion or blood products.
EVAR patients require regular follow up in order to detect complications in early stages of the procedure. Therefore regular CT scans are carried out at 1 month, 3 months and 12 months after EVAR. Then every year after that to ensure that there are no problems. While there is no need to scan patients after open surgical repair. Patients are reviewed in the vascular surgical outpatient clinic about 6 weeks after open surgical repair and if all is well no further check up is required.
According to the "30 day mortality rate" fewer patients die if they undergo EVAR procedure rather than open surgical repair. The "30 day mortality rate" is approximately 2% following EVAR compared to 5% following elective open surgical repair.

Conclusion:

AAA (Abdominal Aortic Aneurysm) occurs mostly in Caucasian males over the age of 65. It is not that common in women. Smoking is considered as one of the most significant risk factor for AAA. The mortality rate is high due to rupture, making repair and detection crucial. Most Abdominal Aortic Aneurysms are asymptomatic and are detected on X-rays done for other reasons.
By offering EVAR procedure and services, Dr. Khalid Shafiq is opening a door to an innovative procedure that can save countless lives in our community.


Dr. Vasquez explaining the EVAR procedure at Paris Cardiology Center.	Picture of (AAA) Stent Graft used in the EVAR Procedure.	Physicians and Allied Health Professional at the EVAR Procedure talk arranged by Dr. Shafiq at Paris Cardiology center.	Picture of (AAA) Stent Graft in Abdominal Aorta.



Refreshments were served at Paris Cardiology Center after the EVAR Talk.	Dr. Khalid Shafiq and Dr.Javier (Jay )Vasquez at Paris Cardiology Center.	Dr. Shafiq introducing Dr. Jay Vasquez for the EVAR Procedure Talk.	The guests listening to the EVAR Talk at Paris Cardiology Center.

Ayesha Shafiq, Director of Paris Cardiology Center. Wife of Khalid Shafiq M.D. and mother of their 2 children. Director of Paris Cardiology Center for 11 years. Masters in International Relations. Runs management with the help of 22 employees.