Ruptured abdominal aortic aneurysms are the 13th-leading cause of adult death in the United States. But they are difficult to detect without testing. Thanks to a quick diagnosis and minimally invasive endovascular repair (EVAR) surgery at UPMC Harrisburg, Doug Boswell is back doing what he loves.
Doug Boswell loves to golf — and in a way, the sport helped save his life.
In April 2021, after playing five rounds, the then-65-year-old from Hummelstown, Pa., felt unusual pain in his abdomen and lower back.
Doug sought help from Katrina Johnstonbaugh, CRNP, a family nurse practitioner at UPMC PinnacleHealth FamilyCare Lower Paxton. He told her he was certain this was more than back pain.
An ultrasound revealed a 9-centimeter abdominal aortic aneurysm (AAA) — much larger than normal.
A Minimally Invasive Solution
Both Doug’s brother and father had AAAs, so he wasn’t totally surprised by the diagnosis.
The aorta is the body’s largest artery, sending blood to every organ. An aneurysm is a thin or bulging area that can develop anywhere along the aorta, but they’re found most often in the abdomen. AAAs are symptomless and are usually identified when testing is done for another issue, like Doug’s back pain.
Doug was referred to Randy Hubbard, MD, an interventional cardiologist at the UPMC Center for Aortic Disease in Harrisburg.
“We usually treat patients when an AAA is enlarged between 5 centimeters and 5.5 centimeters,” Dr. Hubbard says. “Normal size is 2.5 to 3 centimeters. Doug’s aneurysm was almost three times that size. But he had some other medical concerns that needed to be addressed before we could operate, so we carefully monitored his AAA.”
On Sept. 1, 2021, Dr. Hubbard and vascular surgeon Daniel Calderon, MD, performed a minimally invasive endovascular repair (EVAR) on Doug’s aorta. In an EVAR, doctors make a small puncture in the groin and use a stent graft — a fabric tube supported by a wire mesh frame — to reinforce the weakened areas of the aorta.
Doug remained in the hospital that night and now undergoes regular monitoring. The repair should last the rest of his life.
After the surgery, Doug says he moved around pretty gingerly for about a week and a half.
“My surgery was at the beginning of September, and I played nine holes of golf at the end of October,” he says. “My game’s back pretty good now. I don’t even think about what happened.”
UPMC Center for Aortic Disease
At the UPMC Center for Aortic Disease, Dr. Hubbard practices with a team of specialists. Together, they have expertise in vascular and cardiothoracic surgery, cardiology, and interventional cardiology.
“At UPMC Harrisburg, we perform around 100 aortic aneurysm repairs a year,” says Dr. Hubbard. “We review every case as a team, applying our individual expertise and perspective to find the best solution. That’s an important added benefit to our patients.”
Risk factors for abdominal aortic aneurysms
“Many people don’t realize that being a current or former casual smoker can increase their risk of an AAA,” Dr. Hubbard says. “Research shows that smoking as few as 10 packs of cigarettes over the course of a lifetime can increase a person’s risk.”
Other risk factors include:
- Family history of AAA.
- Age (65 and older).
- Gender (more likely to occur in men).
- High blood pressure.
- Diabetes.
- High cholesterol.
Screening is highly recommended for both men and women at higher risk starting at age 65. If there’s a family history of aneurysm, screening should start 10 years earlier, between ages 50 to 55.
“At our center, a major part of our mission is to educate people about their risk for aortic disease, including AAA,” Dr. Hubbard says. “A simple abdominal ultrasound — which is a fast, affordable, and painless imaging exam — can detect AAAs with high accuracy.”
Doug’s treatment and results may not be representative of all similar cases.