ABDOMINAL AORTIC ANEURYSM REPAIR – ENDOVASCULAR

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What is Abdominal Aortic Aneurysm?

The aorta is the largest blood vessel in the body. It delivers oxygenated blood from the heart to the rest of the body. An aortic aneurysm is a bulging, weakened area in the wall of the aorta. Over time, the blood vessel balloons and is at risk for bursting (rupture) or separating (dissection). This can cause life threatening bleeding and potentially death.

Aneurysms occur most often in the portion of the aorta that runs through the abdomen (abdominal aortic aneurysm). An abdominal aortic aneurysm is also called AAA or triple A. A thoracic aortic aneurysm refers to the part of the aorta that runs through the chest.

Once formed, an aneurysm will gradually increase in size and get progressively weaker. Treatment for an abdominal aneurysm may include surgical repair or removal of the aneurysm, or inserting a metal mesh coil (stent) to support the blood vessel and prevent rupture.

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WHAT IS AN ENDOVASCULAR AORTIC REPAIR?

An endovascular aortic repair is done when an aneurysm is very large, growing quickly, leaking, or bleeding.

At times, you may have an abdominal aortic aneurysm that is not causing any symptoms or problems. Therefore, your doctor may have found out about this problem when you had an ultrasound or CT scan.

There is a risk that the aneurysm may 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:

  • Large 

  • Growing more quickly

 

This is a minimally invasive option. This means it is done without a large incision. Instead, the doctor makes a small incision in the groin. He or she will insert small tools through a flexible tube (catheter) in an artery in the groin. The tools are gently pushed up to the aneurysm. Your doctor then places a stent and graft to repair the aneurysm.

POSSIBLE RISKS

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 serious medical problems or are elderly.

However, there are still risks for this type of surgery. 

  • Bleeding around the graft that needs more surgery

  • Bleeding before or after the procedure

  • Blockage of the stent

  • Damage to a nerve, causing weakness, pain, or numbness in the leg

  • Kidney failure

There are also still risks that are associated with any type of surgery. These risks include:

  • Blood clots

  • Breathing problems

  • Infection in the lungs

  • Infection in the urinary tract

  • Infection in the belly

  • Heart attack

  • Stroke

  • Reaction to medication

 

There may be other risks depending on patient's overall health. 

What to expect after the procedure

Depending on the type of procedure, most people stay in the hospital for 3 to 5 days after the surgery. Often, the recovery process for this procedure is faster and less painful than with open surgery.

While at the hospital, you may:

  • Be in the intensive care unit (ICU)

  • Have a urinary catheter

  • Be given medication to thin your blood

  • Be encouraged to sit on the side of your bed and then walk

  • Wear special stockings to prevent blood clots in your legs

  • Receive epidural into your veins or into the space that surrounds your spinal cord

You will need to be watched and checked regularly to make sure your repaired aortic aneurysm is not leaking blood.

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