{"id":5017,"date":"2015-11-11T00:00:00","date_gmt":"2015-11-11T07:00:00","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/2015\/11\/11\/up-close-and-personal-with-aortic-aneurysms\/"},"modified":"2022-08-18T10:22:18","modified_gmt":"2022-08-18T16:22:18","slug":"up-close-and-personal-with-aortic-aneurysms","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/up-close-and-personal-with-aortic-aneurysms\/","title":{"rendered":"Up close and personal with aortic aneurysms"},"content":{"rendered":"
<\/div>

On a recent Friday morning, some 20 young scrub-clad surgeons and engineers\u00a0milled about a large room in the Bioscience Park Center near the Anschutz Medical Campus. After a couple of minutes, they divided into groups and clustered around tables to listen to instructors discuss the fine points of repairing aortic aneurysms.<\/p>\n

\"\"
Attendees gather for vascular surgery conference at the Center for Surgical Innovation Nov. 6.<\/figcaption><\/figure>\n

These were not dry medical lectures, however. At three of the tables, the instructors spoke as they thrust their hands into the open chest cavities of cadavers, exposing organs as the learners looked on intently, taking in the fine points of retroperineal, thoracoabdominal, and paravisceral aortic exposure\u00a0techniques. At a second set of tables, the instruction focused on practicing putting in grafts and suturing on model torsos.<\/p>\n

By the end of the two-hour session, the group had received a flood of information about the repair of aneurysms \u2013 ballooning that weakens the walls of the aorta, the largest blood vessel in the body. Later that afternoon, there was more hands-on training, this time on equipment that allows trainees to simulate advancing and placing endografts within the aorta using the wires, catheters, deployment devices, and X-ray imaging machines that are the tools of the craft.<\/p>\n

The Nov. 6 event, billed as the \u201cMile High Aortic Tech Exchange,\u201d took place in a 1,900-square-foot training facility that is the centerpiece of the Center for Surgical Innovation<\/a> (CSI), a program developed by the University of Colorado School of Medicine. The CU Vascular Surgery and Endovascular Therapy section was co-sponsor with the CSI and CU\u2019s Center for Collaborative Bioinnovation \u2013 a joint initiative of the Bioengineering Department and the Vascular Surgery section.<\/p>\n

Hot ticket<\/strong><\/p>\n

Spots for the gathering filled quickly, said Sarah Massena, executive director of the CSI. That\u2019s been the case since the center moved into the new space last February, she added. The CSI had 71 training sessions for the first quarter of fiscal year 2016 (July 1 to Sept. 30, 2015), well ahead of the total of 159 for all of fiscal year 2015, Massena said.<\/p>\n

\"\"
CU vascular surgeon Omid Jazaeri, MD (left) discusses aortic aneurysm repair with attendees.<\/figcaption><\/figure>\n

A dozen CU surgical program faculty members participated in the vascular surgery event, which was developed and directed by Omid Jazaeri, MD, assistant professor of Vascular Surgery and Radiology. Three invited faculty \u2013 Jason Lee of Stanford; David Rigberg, from UCLA; and Murray Shames, from the University of South Florida \u2013 also participated. An educational grant from medical device manufacturer Medtronic to the CU Foundation paid for most of the expenses, Jazaeri said, but the purpose of the gathering was training and learning, not sales.<\/p>\n

\u201cSometimes there are gaps in knowledge because of a lack of volume of cases and expertise, or practice patterns,\u201d Jazaeri said. \u201cThese educational events allow\u00a0physicians\u00a0with expertise to come together in a focused manner to present trends and data and information about managing aortic disease. There are many different tools and devices to treat aneurysms, and our faculty are skilled in using many medical devices.\u201d<\/p>\n

Jazaeri noted that open and minimally invasive surgical techniques were not the sole focus of the conference. Shames, for example, addressed determining whether or not patients need aortic surgery. Jazaeri discussed radiation safety, and Beth Kujawski, manager of clinical reimbursement for the Department of Radiology at University of Colorado Hospital, provided information about coding for vascular surgical procedures involving aortic repairs.<\/p>\n

Join the club<\/strong><\/p>\n

\"\"
Standing over a cadaver, CU vascular surgeon Mark Nehler, MD (left), talks with trainees about locating a paravisceral abdominal aneurysm.<\/figcaption><\/figure>\n

Rigberg, who is section chief of vascular surgery at Santa Monica-UCLA Hospital, said relatively small, hands-on training sessions like the one at CSI have become more common in the past several years and are especially valued in the vascular surgery community, which is relatively small.<\/p>\n

\u201cEvery vascular trainee attends one at some point,\u201d Rigberg said. The courses aren\u2019t all about learning the newest techniques, either, he added. With the proliferation of endograft repair, for example, training in open procedures is more in demand, he said.<\/p>\n

The meetings are also networking events for the highly skilled, and pathways to future positions for residents and fellows who attend, Rigberg said. \u201cThese are opportunities to meet and work with people who will be future colleagues,\u201d he said. \u201cThey are a huge recruiting tool.\u201d<\/p>\n

Building name, reputation, and relationships is especially important for the vascular surgery fellowship program at CU, which is only two years old, Jazaeri said. Courses that draw clinicians and engineers from around the country \u201cdemonstrate the value of the CSI and the activities we can sponsor,\u201d Jazaeri said.<\/p>\n

He also sees the CSI as a way to \u201cbridge the gap\u201d between clinicians and engineers. The university\u2019s Bioengineering Department, which moved into the new Bioscience 2 building across the street from the Bioscience Park Center last summer, is working with the CSI to give young bioengineers opportunities to observe simulated surgeries and gain a greater understanding of the operating-room and other clinical\u00a0environments.<\/p>\n

The collaboration is a two-way street, Jazaeri said. \u201cI would love to have an engineer in all of my cases to identify unmet needs. As physicians we are taught to be holistic in the care of our patients, and our engineering colleagues are focused and problem solvers.”<\/p>\n

Hand-off to hands-on<\/strong><\/p>\n

But improvements come with familiarity, and the Friday sessions pivoted on the practical. During the morning simulation, CU surgeon Mark Nehler, MD<\/a>, stood over a cadaveric torso, his hands moving organs about as he spoke to the observers. Nehler demonstrated how to locate a paravisceral abdominal aortic aneurysm \u2013 a bulge in the artery where it attaches to and feeds the arteries of the liver, stomach, intestines, kidneys, and colon.<\/p>\n

\"\"
Jason Lee, MD (right), a vascular surgeon with Stanford Health Care, watches a simulation of an endograft at the CSI.<\/figcaption><\/figure>\n

\u201cI\u2019m mobilizing the colon,\u201d Nehler said, as he pushed his way deeper into the cavity with the trainees looking on. He then went on to point to the pancreas and the renal artery, keeping the kidney down while he exposed the paravisceral artery. All the while, Nehler\u2019s listeners peered down intently as his hands worked.<\/p>\n

In the afternoon, high-tech took over, as the trainees worked on devices that simulated the placement of endografts. The simulators allow learners to practice delivering a graft crimped to the end of a delivery device to a weakened aortic wall, using guidewires and catheters threaded through the femoral artery to the diseased area. A simulated X-ray of the structures shows the advance of the delivery device and contrast injected to show the aneurysm clearly. With a twist and push of the device\u2019s long handle, the graft expands within the artery, reinforcing the wall.<\/p>\n

A hole in the simulator stands in for the femoral artery, and small bearings within it mimic the friction the surgeon feels in threading the guidewires and device through the artery, Jazaeri said. The \u201cprocedure\u201d plays out on X-ray, providing another layer of realism.<\/p>\n

\u201cIt allows surgeons to do a case without doing a case,\u201d Jazaeri said. \u201cIt\u2019s a focused and direct way to practice and have discussions about comprehensive care for aortic patients.\u201d<\/p>\n

Next up<\/strong><\/p>\n

\"\"
David Rigberg, MD, vascular surgery chief at Santa Monica-UCLA Hospital, watches as trainees practice suturing a graft to repair an aortic aneurysm.<\/figcaption><\/figure>\n

The vascular surgery sessions were a prelude to other important upcoming conferences, Massena said. Among others, a three-day conference beginning Nov. 13 will draw neurosurgeons interested in radiofrequency and laser ablation of brain lesions. Also on tap are training sessions for spine procedures in collaboration with medical technology device manufacturer Stryker, and two events with da Vinci robotic systems, she said.<\/p>\n

Massena and her colleagues spend dozens of hours organizing the events and juggling travel and lodging logistics for attendees. But it\u2019s gratifying to see the CSI meet its mission, she said.<\/p>\n

\u201cIt all comes down to patient safety,\u201d Massena said. \u201cWe offer surgeons a chance to perfect and practice their skills before they go in the OR. The CSI is a non-stressful environment that encourages learning and asking questions to enhance safety.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

On a recent Friday morning, some 20 young scrub-clad surgeons and engineers\u00a0milled about a large room in the Bioscience Park Center near the Anschutz Medical Campus. After a couple of minutes, they divided into groups and clustered around tables to listen to instructors discuss the fine points of repairing aortic aneurysms. These were not dry […]<\/p>\n","protected":false},"author":2143,"featured_media":1859,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[8],"tags":[335,82,3300,3273],"class_list":["post-5017","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news","tag-anschutz-medical-campus","tag-heart-and-vascular-care-cardiology","tag-heart-surgery-treatments","tag-innovative-medical-technologies"],"acf":[],"yoast_head":"\nUp close and personal with aortic aneurysms - UCHealth Today<\/title>\n<meta name=\"description\" content=\"On a recent Friday morning, some 20 young scrub-clad surgeons and engineers\u00a0milled about a large room in the Bioscience Park Center near the Anschutz Medical Campus. 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