Vascular surgeons from ‘Heart and Brain’ Pleven saved the life of 65-year-old man with abdominal aortic aneurysm

The team of the Vascular Surgery Clinic of ‘Heart and Brain’ Pleven, headed by Dr. Ognyan Matkov, saved the life of a 65-year-old man with a ruptured abdominal aortic aneurysm through endovascular prosthetics. The innovative EVAR method (endovascular prosthetics for aneurysms) was applied for the first time in an emergency operation performed by Dr. Todor Samardzhiev, Dr. Valentin Velikov and their team. The patient was admitted to the hospital in critical condition, with severe abdominal pain and the intervention was life-saving.

“The patient is from the town of. The patient is from Vratsa and sought emergency help from doctors at the local hospital after he developed sudden severe abdominal pain. He had no similar complaints before, was unaware of his health problem and accordingly had no treatment prescribed. After a scan, it was found that the cause of the acute pain was a rupture of the abdominal aneurysm, which necessitated his emergency transport to the hospital in Pleven. The Heart and Brain Hospital is the only one in Northern Bulgaria that routinely performs elective EVAR surgeries,” said Dr. Samardzhiev.

Aneurysms are abnormal enlargement of the diameter of the abdominal (belly) aorta. When the enlargement reaches above a certain size, there is a danger of their rupture, leading to blood spillage into the abdominal cavity. Abdominal aneurysms remain asymptomatic for many years and their first manifestation may be rupture, which is critical and has a high mortality rate. with advancing age their incidence increases.

“The risk of a fatal outcome with open surgery for these conditions is over 90%, so we felt we should implement EVAR. In this method, a covered stent is inserted through the femoral arteries to isolate the ruptured aneurysm from the blood stream,” explained Dr. Matkov. He said that in the vascular surgery clinic they have accumulated a lot of experience in performing elective EVAR operations, but for the first time such an intervention is done in conditions of absolute urgency. In order to perform a standard EVAR procedure, prior preparation and provision of multiple conditions, including those specific to the patient’s own anatomy, are necessary. Time is therefore of the essence, and any delay can be critical.

Thanks to the minimally invasive nature of the method, the man is upright and mobile immediately after surgery, without the need for a stay in intensive care. His condition is stable. The postoperative scan showed complete isolation of the ruptured aneurysm from the endoprosthesis, proving the complete success of the operation.