Vasculary Surgery



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Overview

 


What Is An Endovascular Stent Graft ?

An Endovascular Stent Graft is a tube composed of fabric supported by a metal mesh called a stent.  It can be used for a variety of conditions involving the blood vessels, but most commonly is used to reinforce a weak spot in an artery called an aneurysm. Over time, blood pressure and other factors can cause this weak area to bulge like a balloon and it can eventually enlarge and rupture. The stent graft is designed to seal tightly with your artery above and below the aneurysm. The graft is stronger than the weakened artery and it allows your blood to pass through it without pushing on the bulge. Physicians typically use endovascular stent grafting to treat abdominal aortic aneurysms (AAAs), but they also use it to treat thoracic aortic aneurysms (TAAs) and less commonly, aneurysms in other locations.

Aortic aneurysms are potentially serious health problems since a burst aorta results in massive internal bleeding that can be fatal unless treated rapidly by an experienced emergency medical team. Endovascular stent graft repair is designed to help prevent an aneurysm from bursting. The term “endovascular” means "inside blood vessels." To perform endovascular procedures, vascular surgeons use special technologies and instruments. These procedures require only a small incision or puncture in an artery or vein.

Through these punctures, a vascular surgeon inserts long thin tubes, called catheters, which carry the devices through your blood vessels to the location of the aneurysm. They can then be placed to re-align and strengthen your artery. Generally, endovascular treatments allow you to leave the hospital sooner and recover more quickly, with less pain and a lower risk of complications, and sometimes a lower risk of death, than traditional surgery because the incisions are smaller. Sometimes traditional surgery is required, however, if the shape or the location of the aneurysm is not favorable for an endovascular treatment.  Your vascular surgeon will help you decide what procedure is best for your particular situation. 


How Do I Prepare ?

Your physician will ask you about your medical history and perform a complete physical examination. In addition, your physician may perform several tests, including an electrocardiogram (ECG), which measures your heart's electrical activity, stress testing, which will help to determine your heart health, and a scan to determine if your aneurysm has a favorable shape for endovascular stent graft treatment. If your physician believes that you are a good candidate for endovascular stent grafting, he or she may order one or more of the following tests. These tests show detailed images of your arteries and help your physician choose the correct size and shape of the graft :


  • Spiral Computed Tomography (CT) Scan: This test involves a rapid series of x rays taken in a spiral pattern around your body. A computer transforms the x ray data into three-dimensional images of your blood vessels.
  • Angiography: In these tests, your physician inserts a catheter into one of your arteries. Your physician then injects a dye called contrast through the catheter and takes x rays.


Complications


The potential complications of endovascular stent graft include:

  • Leaking of blood around the graft
  • Infection
  • Movement of the graft away from the desired location (migration)
  • Graft fracturing





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