Joseph The Silent Beat: Read Joseph's Story

"I had taken blood pressure medication for years. After the surgery, my blood pressure is great and there is no need to take it.”

When someone hears the word "aorta," an association is usually made with the heart. Yet, an important connection exists between the aorta and the abdomen — one that should not be ignored if you are at high risk.

It’s called abdominal aortic aneurysm (AAA), a condition that can have serious consequences if it is not detected and treated early. This aneurysm is a blood-filled bulge in a part of the aorta that runs through the abdomen. Over time, the ballooning causes the artery to weaken, and the force of normal blood pressure can cause it to rupture.

Often, an AAA produces no signs or symptoms, and is only found when an unrelated condition warrants attention. Knowing your risk factors can help your doctor with an early diagnosis through careful screening.

Size Makes a Difference

Treatment options depend on the aneurysm’s rupture risk, size and growth. Aneurysms between three and four centimeters will require yearly ultrasound monitoring. Honesto “Sto” Poblete, MD, a vascular surgeon at RWJ Hamilton, says that patients are typically referred to his office if the AAA exceeds four centimeters.

“Treatment of non-ruptured aneurysms depend on size,” says Dr. Poblete. “Patients with the condition are monitored through abdominal ultrasounds every six months. If the aneurysm’s diameter rapidly increases — more than one centimeter in a year or a half-centimeter in six months — surgical intervention is usually recommended.”

Surgical Options

Two types of surgical procedures are available for AAA patients: open aneurysm repair and endovascular aneurysm repair. Open surgery is a
traditional surgical method that involves a sizeable incision into the patient’s abdomen and removal of the aneurysm. The endovascular procedure places a stent in the aneurysm and is less invasive.

“The stent will prevent blood flow from pushing against the wall of the artery,” explains Dr. Poblete. The aneurysm is not completely removed, but the chance of it rupturing is greatly diminished.

Just Ask Joseph

Detected by a cardiologist a few years ago and subsequently monitored, Joseph’s aneurysm had grown to an alarming size. The Yardville resident sought Dr. Poblete’s expertise. First Joseph elected to undergo the endovascular procedure. “Before the surgery, I was sent for a CAT scan,” Joseph recalls. “They used the pictures from that CAT scan to build the stent that they would use to fix my aneurysm.”

According to Dr. Poblete, endovascular repair is more commonly practiced, since both length of hospital stay and recovery time are shorter than open surgery. Patients who undergo the endovascular repair receive a follow-up CT scan every year to monitor the aneurysm’s diameter. Joseph was discharged the very next morning after his procedure.

Other than a slight discomfort while walking, he bounced back in no time at all, and is now taking charge of his well-being. “I do yard work and exercises to get myself back into shape,” he says. “I had taken blood pressure medication for years. After the surgery, my blood pressure is great
and there is no need to take it.”