The Voice in the Ear -- Burt's Stent Blog
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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.

But 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     Dr. Takao Ohki
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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