Twists of fate bring patient to UNC for successful treatment of his abdominal aortic aneurysm

Augustine Elmo was part of an investigational aortic disease stent graft trial to treat extensive thoracoabdominal aortic disease

Twists of fate bring patient to UNC for successful treatment of his abdominal aortic aneurysm click to enlarge This image from Cook Medical shows the placement of a Zenith Fenestrated AAA Endovascular Graft with the H&L-B One-Shot Introduction System for pararenal repair.

Five years ago, Augustine Elmo was living in Charlotte with his wife, Janet, when he hurt his back.  He went to his doctor for treatment, and unbelievably, his doctor discovered that Elmo had kidney cancer unrelated to his back injury. 

“I had a growth on each kidney,” explains Elmo. “The doctor said I was lucky I had hurt my back because odds are, my cancer would not have been discovered until it was very advanced.”

Fast forward to the end of his cancer treatment.  As Elmo was finishing his treatment, his physicians then discovered a pararenal aneurysm.  A pararenal aneurysm is located in the abdomen near the kidneys. 

“My physician said that usually they don’t find these aneurysms until the patient had died from it,” exclaims Elmo. “So while I discovered my cancer because of my back injury, I discovered my aneurysm because of my cancer!”

The twists of fate continued for Elmo when he and his wife decided to move to Durham to be closer to their son’s family.  When they arrived in Durham in the fall of 2013, Elmo’s pararenal aneurysm had grown larger, making a repair necessary.  His physicians in Charlotte had no way to treat the aneurysm except by an open-abdomen surgery, an option that was not appealing to Elmo.

His Charlotte-based physician recommended Elmo be treated by Mark Farber, MD, director of the Aortic Disease Management program at the University of North Carolina.  Not only did Elmo’s physician say, “I would let him operate on me” but Dr. Farber is only one out of five physicians in the United States approved by the FDA to implant and study a stent-graft for the treatment of complex (Type II, III, and IV) thoracoabdominal aortic aneurysms (TAAA), the kind of aneurysm that Elmo had. The study includes a modification allowing Dr. Farber to have access to custom-made devices that treat extensive thoracoabdominal aneurysms, including those starting distal to the subclavian artery. 

UNC is the only center in the Southeastern United States to have access to this technology. Only four other centers in the country have access to the same devices, which include the Zenith® p-Branch and Zenith Physician Specified TAAA device. This allows patients who traditionally would have had large incisions, often extending from their upper back to below their belly button, to be treated with stent grafts through much smaller incisions.

Dr. Farber performed Elmo’s endovascular procedure in June 2014.  He inserted ten different stents into Elmo’s abdomen.

 

“I had the procedure on Monday and went home on Wednesday,” says Elmo.  Other than soreness from the incisions in his groin and arm, through which the endovascular procedure was performed, he felt good.  At his follow-up appointment three months after the procedure, Dr. Farber confirmed the success of the procedure, telling Elmo he could “do whatever he wanted.”

“I’ve had no issues,” says Elmo.  Elmo is also cancer-free, and due to some amazing twists of fate, Elmo is enjoying his retirement with his wife and relishing time spent with his son, daughter-in-law, and new grandson.

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If you would like more information on participating in UNC’s cutting-edge aortic aneurysm clinical trial program, contact Dianne Glover, RN, Research Program Manager for UNC Aortic Disease Management, at (919) 843-1278 or dianne_glover@med.unc.edu.

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