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| Contact: Christine Hill 612-873-5719 |
01/10/08 |
Stroke doctor uses a heart stent to treat an aneurysm caused from dog attack
On March 26, 2007, Paula Ybarra was attacked by a neighbor's bulldog, sustaining life-threatening injuries to her neck, including damage to one of the main arteries that carries blood to the brain. One of Ybarra's two vertebral arteries, located on either side of the vertebrae in the neck, was torn during the attack. Ybarra has had a long recovery of her other injuries and is doing well, but the tear in the right vertebral artery -- called a dissection -- did not heal. She even developed small strokes in the brain as a result of small blood clots that developed near the area of neck injury.
Despite best medical therapy, the tear in the blood vessel did not heal and also developed into a pseudo-aneurysm (like a protruding balloon). This pseudo-aneurysm could burst and cause life-threatening bleeding, or it could be a source for more blood clots that could result in further strokes.
On Wednesday, January 9, 2008, Stroke and Interventional Neurologist Dr. Vallabh Janardhan of Hennepin County Medical Center's Stroke Team decided to try a novel endovascular approach adapting a covered heart stent (also called a stent-graft) to treat this aneurysm that had developed due to the tear in the right vertebral artery. Through a key hole in the groin, Dr. Janardhan and his team of doctors were able to pass catheters and wires to get access to the neck blood vessels, and a covered stent was placed in Ybarra's damaged artery. The artery is now fully functioning without any complications.
"From a technical perspective, it's a new procedure to adapt cardiac stent-grafts for use outside the heart to help reconstruct neck and brain blood vessels," explains Dr. Janardhan. "In the past, the vertebral artery may have been closed up to avoid further complications and she would have lived off only one vertebral artery. But this way, Paula's artery has been reconstructed and is as good as new, and both her vertebral arteries supplying the brain are functioning." Dr. Gustavo Rodriguez and Dr. Qaisar Shah are Stroke and Interventional Neurology fellows who work with Dr Janardhan, and assisted Dr. Janardhan in this innovative procedure.
Today's procedure differed from the stroke interventions Dr. Janardhan performs at Hennepin. "We have a great team out here at the Minnesota Stroke Initiative and at Hennepin County Medical Center. We're doing cutting-edge therapy, and it's exciting to use procedures and devices that have shown promise in other parts of the body and adapt them for the neck and brain to improve the outcomes of our patients. In Paula's case, it's an excellent ending to a very tragic story."
"I feel great, and I'm so glad to have this taken care of this in the new year," says Ybarra, who required only an overnight observational stay at Hennepin after the procedure. "It's a new beginning for me," says Ybarra.
The Hennepin Stroke Center at Hennepin County Medical Center is a national leader in treatment of ischemic and hemorrhagic strokes with some of the fastest clot-busting drug delivery times in the U.S. Hennepin County Medical Center is a Level 1 Trauma Center and public teaching hospital recognized as one of America's best hospitals by U.S. News & World Report for the eleventh year in a row.
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