Thu May 16, 2013
URMC Lab Mixes Medicine and Engineering to Tackle Challenges in Vascular Surgery
Abdominal aortic aneurysms are one of the top ten causes of death in men over the age of 55, and upstate New York has higher rates of this condition than the rest of the country.
Researchers are now working on patient-specific diagnosis and treatment for the condition.
Aortic aneurysms are an enlargement in the lower part of the major blood vessel supplying the body. Imagine forcing a tennis ball into a garden hose and not knowing if the outside of the hose will split. If an aneurysm splits, or ruptures, it can cause life-threatening bleeding.
Dr. Ankur Chandra, a lead investigator at the University of Rochester’s cardio-vascular engineering lab (CVEL), says the prevalence of aortic aneurysms and ruptures in upstate New York points to a need for increased screening.
“One thing about the Western New York and upstate region that’s critically important is that the prevalence, meaning the number of patients in this region with aortic aneurysms is unusually high when compared with the rest of the country,” Chandra says.
“We are not doing an adequate job in the region of screening for this particular disease process and catching patients at a time where we could diagnose them and offer them early repair.”
But, Chandra says even with more people being screened, it’s still very difficult to determine the risk factor for each patient.
“The biggest problem we have is, the patients that we do screen and identify aneurysms in, those patients we still don’t have a good idea outside of this size criteria as to whether or not their aneurysm will rupture at some point in their life or not.”
Patient specific diagnosis and treatment
That’s the problem the CVEL has been tackling, colleague Doran Mix explains.
Mix says the lab has developed a system that uses patient scans to make a 3-D printed copy of the patient’s own aneurysm, giving them the ability to assess the risks for each individual.
“We’ve developed a unique system that allows us to, outside the body, re-create an aneurysm, stress it to rupture and look at the specific mechanics of what makes an aneurysm at risk to rupture, which is a specific question that has not yet been answered by clinical studies and would have to be answered by rigorous engineering analysis.”
Mix says it’s the unique mix of medicine and engineering found in their lab that allowed them to create this diagnostic tool.
Chandra says their approach is in sync with the direction of the health care industry.
“Patient-specific diagnosis and treatment will allow us to do away with unnecessary surgeries and operations, but also provide the highest return for that investment. So we’re doing surgery in the patients with the highest risk.”
The long term goal is to be able to repair aneurysms with devices individually tailored to the specific patient, similar to the approach taken with prosthetic limbs.
“The ultimate long term ideal would be that, as we identify characteristics of patient’s blood vessels that, we actually create and are able to create on the spot, devices that are compatible in material properties with those patient’s blood vessels to provide them with the most natural replacement for their aneurysm,” Chandra says.
The cardio-vascular engineering lab (CVEL) includes a cross-disciplinary team from two universities, working to solve cardiovascular problems using engineering principles. It houses surgeons, cardiologists and medical students from the University of Rochester Medical Center, and engineering students and faculty from the Rochester Institute of Technology.
Dr. Chandra says their lab is unique in the upstate area. He says this allows them to solve many small problems along the way to solving the larger problems in cardio-vascular health.
He says their patient specific diagnostic tool could lead to differences in the timing and method of treatment for some patients, depending on individual needs.
The CVEL has won a grant from the Clinical and Translational Science Institute and UNYTE to continue their research into abdominal aortic aneurysms.