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St. Michael’s adds another world first

Toronto, May 1, 2014

By Geoff Koehler

Dr. Andrea Covelli
Dr. Tony Moloney was the world’s first to use Cook’s new Alpha graft. He’s shown here performing a different vascular procedure. (Photo: Permission for use granted by Cook Medical Incorporated, Bloomington, Indiana)

When Cook Medical chose to debut the newest model of its endovascular stent graft to the world, it chose an experienced team at St. Michael’s Hospital.

Dr. Tony Moloney, an endovascular surgeon with the Heart and Vascular Program, was the first to use Cook’s new Alpha graft to repair a patient’s aorta and treat an abdominal aortic aneurysm.

An abdominal aortic aneurysm, often called a “Triple-A,” is when part of the aorta –the largest artery in the body– is weakened and may rupture. One way to repair the aorta is with an endovascular stent graft – a tube containing a mesh stent that will expand and support the artery’s weak spot.

Surgeons insert stent grafts through the femoral artery and deftly lead it up to the damaged area. When they’ve reached the correct spot, surgeons pull on a cord and release the compressed mesh. That mesh expands to fit the exact framework of the patient’s injured arterial wall and provide structural support.

“Rather than pulling on a cord, the Alpha graft is released with a twisting motion,” said Dr. Moloney. “A twisting release gives us more control and stability which should be safer for patients and make placement more precise.”

Placement is crucial when it comes to repairing an aneurysm. If you’re off by a few millimeters, the aorta may not get the structural support it needs. Having a stent graft that is small enough to maneuver through tight spots can be the difference between having a minimally invasive procedure, such as a stent graft, and undergoing surgery. The Alpha graft is slimmer than Cook Medical’s other endovascular grafts so access is easier.

"Other medical device companies have grafts that are similarly slimmer or released with the twisting motion,” said Dr. Moloney. “But because each aorta is different, we need many different kinds of grafts. With this world-first, we’ve added a new arrow to our quiver.”

About St. Michael's Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael's Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.