Pain Reveals Hidden Danger

Nobuko McClellan (center) enjoys time with her daughter, Janet, and her grandson, Duran, 2.

Nobuko McClellan, 60, tried to convince herself that she was just tired. After all, she had just moved into a new home in Vacaville, and she’d been in overdrive, trying to get everything fixed up just right. She’d painted. She’d carried in boxes. She’d put heavy books into the bookcase. It was just too much.

So she went to bed on July 24, 2010, trying to convince herself that she’d be fine in the morning.

By 2 a.m., she could hardly breathe. “It was painful to inhale, it was painful to exhale,” she recalls.

She called a friend who took her to NorthBay VacaValley Hospital where they ran a battery of tests, specifically checking for heart issues, as she’d had angioplasty seven years earlier. Her heart was fine, but she wasn’t. “My whole body was in pain,” she says.

With pain medication, her symptoms receded, and she was released. But it happened again the next day, so she returned to VacaValley Hospital.

“This time, they did even more tests,” recalls her daughter, Janet, who was camping and out of reach during the first ordeal.

“I called her to tell her that we got home safely, and she said she was in the Emergency Room!”

On the second visit, a CT Scan, EKG and MRI were all ordered, as doctors tried to figure out the source of McClellan’s pain. While that remains a mystery, they did find something else, something potentially life-threatening: A splenic artery aneurysm.

“I didn’t even know what a spleen was,” says Janet. “So I started researching it. They used to remove spleens because they thought they didn’t serve a purpose, but now they realize they filter infections.”

While the aneurysm—approximately 3?4″ in diameter—wasn’t threatening McClellan’s spleen or her life, it posed a risk if it were to enlarge or rupture.

An aneurysm occurs when the walls of a blood vessel balloon outward, creating weakness in the vessel wall. In McCellan’s case, it had formed in the splenic artery.

Although a splenic aortic aneurysm is the third most common type of abdominal aneurysm, they typically have not been treated at NorthBay Medical Center. In the past, patients were referred outside of Solano County for extensive abdominal surgery. But Seph Naficy, M.D., a vascular and cardiothoracic surgeon, thought McClellan’s case might be a good candidate for an endovascular procedure.

Sending a wire catheter from the groin into the abdominal artery, then into the celiac artery and then into the splenic artery, he was able to place 10 wire coils and a stent graft across the neck of the aneurysm.

While either the coils or the stent graft may have been enough to prevent future problems, Dr. Naficy felt it best to take the “belt and suspenders” approach, going above and beyond to ensure the patient’s safety, he says.

McClellan checked in to NorthBay Medical Center’s Same Day Center around noon, and she was home by 5 p.m., ready to heal. “I was walking by the second day,” she says. “It’s amazing.”

Dr. Naficy agrees, pointing out that the technology is key. “The CT scan showed us something we wouldn’t have seen otherwise. She had no symptoms, but we were able to protect her from a possible rupture. And we were able to do it in a much less invasive way, so she’s up and walking as soon as possible and back to living her life.”

Photo (A) shows the aneurysm branching off the splenic artery. (B) shows a catheter placed into the splenic artery aneurysm. (C) shows coils placed into the aneurysm which will clot the blood flow in the aneurysm. (D) shows a covered stent placed across the entry point into the aneurysm.

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