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Carlos Timaran, M.D. Answers Questions On: Aortic Endovascular Surgery
How is technology changing the way you treat patients with abdominal aneurysms and other vascular problems?
We have many more options to offer our patients than we did even just a few years ago. For example, today most people who have an aneurysm can be treated with a covered stent that is placed inside the vessel through a minimally invasive procedure. But up until a few years ago, patients with complex aneurysms would have to undergo open surgery.
We currently have access to fenestrated graft devices at UT Southwestern Medical Center, which allows us to offer custom-made stents to these patients – and we can fix almost any aneurysm this way. We are one of only five centers in the U.S. that has access to this device. We are also approved to use several investigational devices, which means we can offer our patients almost any existing technology to treat their condition.
I also collaborate on complex vascular cases with surgeons in medical centers all over the world, including South America, Mexico, Spain, Italy, and China. Through those collaborations I’ve been able to work with technology that very few people in the United States have access to, and I can bring this experience to my patients at UT Southwestern.
Do all patients need these advanced surgical devices?
There’s plenty of controversy in the medical community about who benefits from what, in terms of open surgery versus minimally invasive techniques, or surgery versus medical therapy. At UT Southwestern we’re participating in a few NIH clinical trials that will help us answer some of these questions – to better understand when it’s necessary to operate on patients, and what type of procedures are best for each patient.
With the growing number of options available for treating vascular disease, how does a patient know what procedure is best or which specialist to choose?
I believe every patient is unique, and so what’s best will vary from patient to patient. Although minimally invasive techniques can work for many patients, there are still patients who will need open surgeries, and in that regard it’s very important to have a physician who has the experience to skillfully select the right procedure at the right time.
The advantage that we have at UT Southwestern is that all of our vascular surgeons perform both open surgery and minimally invasive procedures. I’ve done close to a thousand stents, and I perform a fair amount of open surgeries. That gives me the experience to decide what is better for the patient and the expertise to offer the patient whatever procedure he or she needs.
Because we have on hand the latest equipment, technology, and almost every available device, we’re able to offer patients the full range of options, and I think that’s invaluable.