HSA offering the ‘gold standard’ for endovascular repair The repair of an abdominal aortic aneurysm is a difficult procedure normally only offered in centres with large populations; such as the United States and the United Kingdom however Dr Robin Windhaber, a surgeon at the Cayman Islands Health Services Authority (HSA), has recently successfully performed the procedure on a patient, here in Cayman. Dr Windhaber, Vascular & General Surgeon at the HSA said Cayman can now provide a service that is considered very specialized globally.“An abdominal aortic aneurysm (AAA) is a condition where the aorta (the main blood vessel in the body) develops a bulge, usually in the abdominal aorta which can form an aneurysm. If an aneurysm ruptures it can be fatal,” Dr Windhaber said.“A traditional standard repair has a mortality rate between 5 to 10%, and patients stay in hospital for seven to ten days, taking a minimum of 6 weeks to recover. But in suitable patients, endovascular repair (EVAR) can be done through small incisions and the placement of a stent inside the aneurysm. Patients normally go home the following day and there is only a 0.5 to1% mortality rate,” he said.“Before working at the HSA, I previously worked in the UK treating about 70 to 80% of patients using this procedure. EVARs were only offered in large centres serving a population over 850,000 people,” Dr Windhaber said. “In the US the procedure is generally only available at specialised vascular centres. At the Health Services Authority we now have the ability to provide elective and emergency AAA repairs with both open and EVAR surgical techniques. We now offer patients exactly the same service here at the HSA that I could offer as a specialist vascular and endovascular surgeon in a large vascular centre in the UK.”Ms Lizzette Yearwood, Chief Executive Officer at the HSA believed this is the first time such a procedure has been carried out in the region.“This is most certainly the first time an EVAR has been performed in the Cayman Islands and we believe it is most unlikely that it has been performed at any major hospital within the Caribbean,” Ms Yearwood said. “Previously a patient would have to be flown off island to a large hospital within the US to have this specific surgery.  Such a procedure is generally considered the gold standard for treating AAAs so we are very pleased we can offer such an important and potentially life-saving service here locally.”Since Dr Windhaber has started working at the HSA in August 2013, he has performed numerous surgeries to local residents that have not been available previously.Such procedures have included the first Carotid Endarterectomy, Catheter Directed Thrombolysis for DVT (Deep Vein Thrombosis), Insertion of Inferior Vena Cava Filter, Hybrid procedure and ultra-distal bypass graft, intra-arterial stenting and first endovascular treatment of arterial trauma, treatment of central vein occlusion with intravenous stent, and intra-arterial embolization procedure to treat traumatic arterio-venous fistula of leg.“I am delighted that Dr Windhaber has brought his expertise to Cayman as we strive to enhance our patient’s experience by offering such advanced services at the HSA,” Ms Yearwood said.Visit www.hsa.ky for more information and services offered at the Cayman Islands Health Services Authority.