Vim & Vigor - Winter 2020 - UVA - 8

8
Megan Tracci, MD. "At UVA, we follow the
more inclusive AAA screening guidelines
developed by the Society for Vascular Surgery
that recommend a one-time AAA screening
for both men and women age 65 to 75 who
have ever smoked [see complete screening
guidelines at right].
"I believe we ought to be very thoughtful about screening women for aneurysm,"
Dr. Tracci adds. "Although these occur less
frequently in women, we know the rate of
rupture is as much as four times higher than
men. And in an era when we are taking into
account things such as life expectancy and
quality of life when planning major interventions, we have to consider that women
continue to live longer."

In addition, women are more likely to
have abnormal anatomy or smaller vessels
that can hinder the use of less-invasive
EVAR technology. For them, open surgery
may be the better solution.
"Everyone is afraid of having a big operation," Dr. Tracci says. "But some people,
when they realize they will need annual
surveillance after EVAR and there's a risk of
needing reintervention due to later complications, choose the 'one and done' option.
The reality is, we've been fixing aneurysms
using traditional surgery since the 1950s,
and it remains a relatively safe, very effective treatment."

SUCCESS WITH OPEN SURGERY

Mairs opted for open surgery. She was
DECISION TO TREAT
a great candidate because of the location
The risk of rupture led Mairs to quickly seek
of the aneurysm and her overall health,
treatment. "I could've waited and taken the
according to Dr. Tracci. "Mrs. Mairs had an
chance of it rupturing and killing me or doing aneurysm that involved the kidney arteries.
surgery," she says. "I went with surgery."
There are endovascular solutions for that,
"At 5.8 centimeters, her aneurysm was
but they come with a higher complication
pretty large," Dr. Tracci says. "We
rate and may not be as durable,"
know that in women, aneurysms
Dr. Tracci says.
In women,
on the smaller end of this range
"I had all the confidence in the
abdominal
are more likely to rupture, so we
world in my surgeon, and I did
aortic
aneurysms
are particularly attentive and think
really good," Mairs says. "I recovoccur less
about repairing these sooner."
ered very quickly. Within two
frequently,
Like many medical procedures
weeks, I was back to doing almost
but the rate of
today, AAA repair is often pereverything I normally do on my
a dangerous
formed using minimally invasive,
own. Even the physical therapists
rupture is as
endovascular techniques, and for
were amazed at how quickly I came
much as
good reason: There is less pain
along with recovery."
and a shorter recovery time with
For Dr. Tracci, Mairs is the perendovascular surgery (using small
fect example of aneurysm repair
higher than
incisions and tubes or catheters to
gone right. Open aneurysm repair
in men
access parts of the body via blood
is not always the easiest option for
vessels). Most important, death
the patient or the provider. It takes
and serious complication rates at
surgical expertise that is beginning
the time of surgery are lower.
to wane with the shift to endovasWe now know, however, that
cular procedures, Dr. Tracci says.
endovascular aneurysm repair
"As minimally invasive techniques
(EVAR) is not the best long-term
have taken over nationally-and
Megan Tracci,
option for everyone. "Studies show
rightly so-the level of experience
MD,
the survival advantage we see with
among surgeons in open surgery has
UVA vascular
surgeon
EVAR disappears by around five
dropped. So there are potentially
years," Dr. Tracci explains. "This
fewer people who feel comfortable
is likely for a variety of reasons,
doing open interventions," she says.
one being that the rate of certain
"However, some patients have charaneurysm-related complications that occur
acteristics that we know are better treated with
years after endovascular AAA surgery is
open surgery rather than a catheter-based
higher compared to open surgery. Thus, there's procedure. At UVA, we have the surgical
a higher rate of reintervention; people often
expertise required to offer patients the repair
need follow-up procedures to tune things up."
option that's best for them." *

4X

Should You
Be Screened
for Abdominal
Aortic
Aneurysm?
If you meet the following
criteria, you should receive a
one-time screening for AAA,
based on guidelines by the
Society for Vascular Surgery:
Men and women ages 65
to 75 with a history of
tobacco use
Men and women older
than 75 with a history
of tobacco use who are
in good health
Men and women older
than 65 with a family
history of abdominal
aortic aneurysm

Vascular
Screening:
A Low-Cost
Lifesaver

UVA Heart and Vascular
Center offers inexpensive
and comprehensive vascular
screening, which includes
ultrasound screening for an
abdominal aortic aneurysm.
Learn more at uvahealth.com/
vascular-screening.

WINTER 2020 VIM & VIGOR

V1_VVWI2088_06-08_AorticAneurysm.indd 8

9/21/20 4:00 PM


http://www.uvahealth.com/vascular-screening http://www.uvahealth.com/vascular-screening

Vim & Vigor - Winter 2020 - UVA

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Contents
Vim & Vigor - Winter 2020 - UVA - Cover1
Vim & Vigor - Winter 2020 - UVA - Cover2
Vim & Vigor - Winter 2020 - UVA - Contents
Vim & Vigor - Winter 2020 - UVA - 2
Vim & Vigor - Winter 2020 - UVA - 3
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Vim & Vigor - Winter 2020 - UVA - 5
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Vim & Vigor - Winter 2020 - UVA - 18
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Vim & Vigor - Winter 2020 - UVA - 20
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Vim & Vigor - Winter 2020 - UVA - 29
Vim & Vigor - Winter 2020 - UVA - 30
Vim & Vigor - Winter 2020 - UVA - 31
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Vim & Vigor - Winter 2020 - UVA - 38
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Vim & Vigor - Winter 2020 - UVA - 53
Vim & Vigor - Winter 2020 - UVA - 54
Vim & Vigor - Winter 2020 - UVA - 55
Vim & Vigor - Winter 2020 - UVA - 56
Vim & Vigor - Winter 2020 - UVA - Cover3
Vim & Vigor - Winter 2020 - UVA - Cover4
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