But sometimes, crucial information can be found online, as proven by Thomas Sullivan. Sullivan, 72, a retired engineer from Cedar Falls, Iowa, was diagnosed in November 2000 with an abdominal aortic aneurysm. A major artery, the normal aorta can be felt in thin people as a pulsing tube deep inside the abdomen. If there is an aneurysm (generally caused by a slow weakening of the blood vessel wall), this tube will seem overly large.

Occasionally the wall of the aneurysm will leak, and may suddenly break. If the wall of a major blood vessel breaks, it is often fatal, which is why abdominal aortic aneurysms have been called a ticking time bomb for men over age 60.

"I could not sleep on my stomach because the aneurysm was throbbing/pounding so much at night, actually raising my body off the mattress if I was sleeping on my stomach," Sullivan said. "I could feel every heartbeat through the aneurysm."

It may not be necessary to treat a small abdominal aortic aneurysm (doctors do not generally intervene unless the aneurysm exceeds 5.5 centimeters in men and 5 cm in women), but it's important to closely monitor the problem. Sullivan's physician decided to see if the aneurysm enlarged a bit before performing the traditional surgery, which begins with a long incision in the abdomen. Surgeons have performed this procedure for more than 30 years with excellent results; however, it is also a major surgery that requires a month's recovery.

With his aneurysm swollen to above 5 cm, Sullivan elected to search the Internet for more information. That's when he hit upon the University of Iowa Hospitals and Clinics Web site. There he read about an endovascular repair involving a device known as a stent-graft, a relatively new, less invasive approach that he appeared to qualify for unless the aneurysm got too large.

He requested a transfer to UI Hospitals and Clinics, where he received care from Jamal Hoballah, M.D., a leading vascular surgeon.

"The procedure involves the insertion of an artificial tube reinforced by a stent (all about the size of a pinky)," Hoballah said. "Instead of large incision in the belly, two incisions are done in the groin. We pass a special wire up to where the aneurysm is located, then introduce the device and uncover the stent-graft under x-ray guidance."

The graft expands within the aorta, taking away the pressure in the aneurysm. "Basically, we are re-routing the blood from within. The blood goes through the stent-graft and avoids contact with the weakened artery," Hoballah said. "Patients recover much more easily from this procedure and typically are ready to go home on the second day, or at the most within 48 hours of the operation. They are ready to resume their typical routines within a week."

When Sullivan found out the problem has a hereditary component, he talked to his four brothers. They subsequently received screening by ultrasound, and one of them, Richard, 77, also was diagnosed with an aneurysm. Both brothers underwent the stent-graft procedure, and both came away with excellent early results. "It was just like getting a whole new heart," Richard Sullivan said.

"Both brothers are doing very well," Hoballah said. "The grafts are working and the aneurysms have even shrunk."

Whether an individual is a candidate for this procedure usually depends on the anatomy of the aneurysm. For more information, call UI Health Access and ask for the vascular surgery office, or call the office directly at 319-356-8242. Physicians should call UI Consult. Appointments can be made directly by calling 319-356-2902.

For more information:

Jamal Hoballah, M.D.

UI Health Access

UI Consult