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April
11,
2010 -- 9:10pm EDT
"I'm a Dead Man"
That's what patient R.B. said to his family
when he was told by two different surgeons that his abdominal aortic
aneurysm could not be repaired. It was large -- more than 7cm --
and in
danger
of
rupturing -- fatal
four out of five times. Such aneurysms had been repaired surgically
for almost half-a-century, but not for this patient. He had COPD,
chronic obstructive pulmonary disease, and he would not survive
a major traumatic surgical procedure that involved opening his
chest
and putting him under general anesthesia. As he told me during
a 2001 interview for my documentary, "Vascular
Pioneers":
You can't put the feeling that one gets
on tape or on paper or anything else when one is told, "You're
not a candidate. You're dead." There's nothing that can
describe that feeling. I wept. I cried. I could do it again
right now.
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what his surgeons didn't know in the year 2000 (cue Conan) was that
only a few miles away a new type of aneurysm repair was being done,
using a stent graft, delivered like angioplasty via catheter through
the femoral artery -- no general anesthesia, no opening of the chest
cavity. Maybe his surgeons didn't know about it --
but there
was this thing called the Internet -- and using this tool, our patient's |
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Dr. Takao
Ohki |
good friend found Dr. Takao Ohki, then at Montefiore
Hospital in New York City, where the first endovascular AAA repairs
were done.
Within a few weeks, he visited with Dr. Ohki who determined
that R.B. was in fact a candidate for this minimally invasive procedure.
He did it, it was successful. And here a year later the patient was
talking to me on camera.
So the anecdotal experience of feeling the emotions
of this patient very much informs my interpretation of the two
studies published today in the New England Journal of Medicine.
There are charts and graphs and tables, and 30-day outcomes and five-year
outcomes...but I remember the man who would not be sitting
in from of me were it not for this ingenious metal cage covered in
fabric.
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