Aortic aneurysm repair - endovascular - Overview

Definition of Aortic aneurysm repair - endovascular:

Endovascular abdominal aortic aneurysm repair is surgery to fix a widened part (or aneurysm) in your aorta, the large artery that carries blood to your belly, pelvis, and legs.

An aortic aneurysm is when a part of this artery becomes too large, or balloons outward, due to weakness in the wall of the artery.

Unlike standard surgery, in which a surgical cut is made in the abdomen, endovascular aortic repair is done without any major surgical cut.

Description:

You will lie on a padded table in an operating room, in the radiology department of the hospital, or in a catheterization lab. You may receive general anesthesia (you are asleep and pain-free) or epidural or spinal anesthesia.

• Your doctor will make a small surgical cut near the groin, to find the femoral artery. Then your doctor will insert a stent (a metal coil) and a manmade (synthetic) graft through the cut into the artery.
• The doctor uses x-rays to guide the stent graft up into your aorta, to where the aneurysm is located. The doctor will open the stent using a spring-like mechanism and attach it to the walls of the aorta. Your aneurysm will eventually shrink around it.
• The doctor will then use x-rays again to make sure the stent is in the right place and your aneurysm is not bleeding inside your body.

Why the Procedure Is Performed:

Endovascular aortic repair is done because your aneurysm is very large, growing quickly, or is leaking or bleeding.

You may have an abdominal aortic aneurysm that is not causing any symptoms or problems. Your doctor may have found out about this problem from tests called an ultrasound or CT scan. There is a risk that this aneurysm may open up (rupture) if you do not have surgery to repair it. However, surgery to repair the aneurysm may also be risky. In such cases, endovascular repair is an option.

You and your doctor must decide whether the risk of having this surgery is smaller than the risk of rupture if you do not have surgery to repair the problem. The doctor is more likely to recommend that you have surgery if the aneurysm is:

• Larger (about 2 inches or 5 cm)
• Growing more quickly (a little less than 1/4 inch over the last 6 to 12 months)

Endovascular repair has a lower risk of complications compared to open surgery. Your doctor is more likely to suggest this type of repair if you have other, more serious medical problems or you are elderly.