Pioneers in patient care: consultants leading change
Midlands
Innovation: Stenting of aortic aneurysms
Professor Peter Bell
Leicester Royal Infirmary, Leicester
Job title: Professor of surgery
Specialty: Vascular/ transplant / endocrine surgery
Over five per cent of men over the age of 61 suffer from an aortic aneurysm, a life threatening condition in which the aortic artery swells due to the pressure of blood flowing through a weakened area. The condition results in around 10,000 deaths a year in the UK. Treatment for aortic aneurysms means a major operation, requiring weeks of recovery time, but an innovation led by Professor Peter Bell, Mr Matt Thompson and Dr Guy Fishwick means patients can be treated quickly and recover from the operation in a matter of days.
Traditional treatment of aortic aneurysms involves a large incision through the stomach, attaching a plastic graft from one unaffected end of the artery to another. The stent graft method is done using keyhole surgery, as Professor Bell explains: “The stent graft method is completed inside the artery, rather than outside the artery as is the case with the more traditional procedure. A small incision is made into the groin and a tube is inserted under x-ray guidance. Inside the tube is the plastic graft resting on a metal spring called a stent. Once the tube reaches the unaffected part of the artery the plastic graft springs into place and is held there by the stent. The process is then repeated from the unaffected area of the artery at the opposite end, thereby bypassing the aneurysm within the artery.”
One of the reasons the innovation was introduced was to tackle patient mortality, as those with aortic aneurysms are generally older and less able to cope with the trauma of a big operation. Professor Bell says: “The stent graft is a far less traumatic procedure, and patients are back on their feet in a matter of days. Previously it could have taken weeks for the patient to recover. We have also found that the procedure cuts down on complications and therefore patient survival rates have also improved. Our patients have responded very enthusiastically to the method and around 70 per cent of the people we see are suitable for the procedure.”
Professor Bell describes the funding for the service as ‘ad-hoc’. The service could be improved with an increase in resources: “There is little funding for stent grafts, and we need more doctors, more nurses and access to better equipment. There also needs to be a reduction in the amount of bureaucracy and excessive form-filling we face as doctors.”