When Rudy and Irene Matyas planned their retirement, they chose to stay close to Doylestown. It was a decision the couple says they have never regretted – especially when an aneurysm put Rudy's lone kidney at risk, making access to high-level vascular care available at Doylestown Health a necessity.
A former program supervisor with the Bucks County Intermediate Unit, Rudy, 86, had an infrarenal abdominal aortic aneurysm, a ballooning of the body's main artery, right below his kidney. Without repair, he would be at risk for a life-threatening rupture, yet the treatment could impact the functioning of his kidney.
Fortunately, Joshua Eisenberg, MD, fellowship-trained vascular surgeon with Doylestown Health Vascular Surgery, offered the expertise Rudy needed.
Weighing the Options
"Dr. Eisenberg was magnificent! He reviewed my pre-surgery tests, consulted with my family physician and nephrologist, and calmly explained my options in terms of risks and rewards," says Rudy. "I was concerned that I would end up on dialysis, but when the time came for my procedure, I had complete confidence in my choice and in Dr. Eisenberg."
Rudy's treatment options included:
Minimally invasive endovascular artery repair (EVAR) – The aneurysm would be repaired from the inside with a stent, delivered through a catheter (thin tube) via the femoral artery. An offshoot artery, discovered during preliminary testing, would have to be removed, potentially creating a problem with the blood supply to Rudy's kidney.
Approximately 70 to 80 percent of aneurysm patients qualify for EVAR, a determination based primarily on anatomy.
Open repair – The traditional method, open repair involves a large incision in the abdomen and replacement of the damaged segment of the aorta with a graft. This option involves major surgery, and would require a longer hospital stay and recovery.
If, during EVAR, Dr. Eisenberg determined that proceeding with an open surgical repair would produce a better outcome, then a "hybrid" procedure, combining endovascular technique and open surgery, would be performed. Doylestown Health's hybrid operating room features sophisticated equipment and imaging technology to allow Dr. Eisenberg to seamlessly move from EVAR to open surgery.
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Making a Decision
"Mr. Matyas' anatomy made endovascular repair challenging," says Dr. Eisenberg. "He had previously had one kidney removed, and had some of the blood supply to his other kidney arising from his aneurysm. Treating his aneurysm in our hybrid OR allowed us to have all of the tools available to ensure he had a good outcome."
"I went for the endoscopic operation (EVAR), and everything turned out perfectly," says Rudy. I was impressed with Dr. Eisenberg, the staff and the pre- and post- surgery preparation at the hospital. Everyone was knowledgeable and supportive. I stayed just one night, and my kidney is functioning fine!"
Vascular Disease and Aneurysm
Vascular diseases affect the circulatory system, which carries life-sustaining fluids throughout the body.
Though common, especially with age, vascular diseases can lead to serious, sometimes life-threatening conditions, according to fellowship-trained vascular surgeon Atul Rao, MD, also with Doylestown Health Vascular Surgery. "The two major arterial system disorders treated by vascular surgeons involve blocked arteries and aneurysms of the arteries."
"The main vessel carrying blood from the heart to the body, the aorta, can bubble out like a balloon and rupture — an immediate, life-threatening catastrophe," says Dr. Rao. "Our goal is to identify aneurysms beforehand, following patients with routine imaging until the aneurysm size meets the indications for repair or symptoms develop."
Advanced Care in a Community Setting
Doylestown Health Vascular Surgery offers advanced diagnosis and treatment of vascular conditions. "Doylestown Health melds the best qualities of a community health system with high-level expertise and facilities," says Dr. Rao. "We have relationships with patients, referring physicians, hospital staff and colleagues, while our patients are supported with diagnostic capabilities, outstanding post-operative ICU settings and excellent nursing care."
- Advanced treatment in a patient- and family-centered environment
- University-level care in a convenient suburban location
- Expertise to oversee all aspects of vascular care
- The newest minimally-invasive endovascular technologies and open surgeries
- Support and education for patients and families
- State-of-the-art technology
- Preventive cardiovascular health programs
- Disease-specific nutrition counseling
- Robust cardiac rehabilitation program
Vascular conditions treated:
- Abdominal and thoracic aortic aneurysms and dissections (tears in the wall of the artery)
- Carotid blockages/cerebrovascular disease
- Deep vein thrombosis (a blood clot in a vein that can break loose and cause blockage)
- Diabetes-related circulatory problems and wounds
- Kidney disease requiring dialysis
- Mesenteric artery disease (intestinal blood flow)
- Peripheral artery aneurysms
- PAD (Peripheral Arterial Disease) and limb ischemia (limited blood flow that can lead to pain or even loss of limb)
- Renal artery disease
- Varicose veins
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