Back to articles

New procedure offered for patients with potentially life-threatening condition


The vascular surgery team at Adventist Health Sonora is now offering a revolutionary treatment for abdominal aortic aneurysm. A minimally-invasive procedure called percutaneous endovascular abdominal aortic aneurysm repair (PEVAR) requires only small punctures to access and repair the aneurysm via the femoral arteries.

“PEVAR has been used in academic facilities and large medical centers for the past several years,” explains vascular surgeon Phong Dargon, M.D. “I am proud to bring this big city procedure to Adventist Health Sonora and provide patients with a safe and effective treatment that allows for less blood loss and a smaller wound with less pain and lower chance of infection.”

Abdominal aortic aneurysm, also known as “AAA” or “triple A,” is fairly common. According to the Society for Vascular Surgery, 200,000 people in the United States are diagnosed with AAA each year. There are usually no symptoms associated with AAA, which is often found when a patient undergoes diagnostic imaging tests for other medical conditions. An aneurysm occurs when part of a blood vessel wall weakens and begins to bulge outward. Over time, the bulge can grow, leading to a potentially fatal rupture. As the largest artery in the abdomen, the abdominal aorta delivers blood to the organs, pelvis and legs. A rupture can lead to serious bleeding that, without immediate treatment, can quickly turn fatal.

When a patient is diagnosed with an aneurysm that is less than 5 centimeters, the patient is typically monitored with an ultrasound or CT scan. If the aneurysm is larger or growing rapidly, surgery is often recommended to prevent rupture. Open surgery requires an incision in the abdomen for the vascular surgeon to access the abdominal aorta and sew a graft into place. The patient recovers in the hospital for several days and fully recovers by three months.

Endovascular aneurysm repair (EVAR) was introduced in the 1990s, providing a less invasive treatment for AAA. The vascular surgeon makes incisions in both groins to gain arterial access. A stent graft is then advanced to the abdominal aorta through the femoral arteries and deployed. The stent relines the inside of the artery to prevent rupture. The patient recovers in one to three days in the hospital and at home for several weeks.

PEVAR eliminates the need for the approximate 4-inch incisions in the groin by using a pen-sized puncture to introduce the stent.

While completing his fellowship in vascular surgery, Dr. Dargon had the opportunity to perform many of these procedures with the Veterans Affairs Loma Linda Healthcare System, which participated in a national study to determine the safety and effectiveness of percutaneous endovascular AAA repair with great success.

In addition to using PEVAR to prevent rupture in the elective setting, it also benefits patients experiencing rupture. Dr. Dargon explains, “Because we can quickly start the procedure without incisions and complete this procedure without incisions to close, the critical patients can be moved to the ICU more quickly to begin their resuscitation.”

Not all patients are anatomic candidates for percutaneous endovascular AAA repair. Risk factors for AAA include older age, male gender, smoking, high blood pressure, and family history of AAA.

More information is available by calling Sierra Vascular at (209)-536-5750.