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.
What Happens During Surgical Aneurysm Repair ?
Your vascular surgeon will make an incision in your skin and muscle above the artery with the aneurysm. For AAA, for example, your surgeon will work through your abdominal wall. If your aneurysm is in your knee, your surgeon will operate in your leg.
Once your surgeon exposes the aneurysm site, he or she will clamp the artery above the aneurysm to stop blood from flowing through the area. Your surgeon next opens the aneurysm and removes the clotted blood and plaque deposits.
Usually, your surgeon will not completely remove your aneurysm. Instead, he or she may cut through the wall of the artery and open it like a butterfly. He or she may then insert a graft that is the same size and shape of your healthy artery. Your surgeon will attach one end of this graft just above where the aneurysm begins and the other end below the end of the aneurysm.
In some cases, your surgeon may remove the aneurysm and replace it with a piece of a vein from your leg, or a man-made graft, if necessary.
Why the Procedure is Performed ?
If you have bleeding inside your body from an aortic aneurysm, you will have open abdominal aortic aneurysm repair. Endovascular repair is rarely done for a leaking or bleeding aneurysm.
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 special 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.
You and your doctor must decide whether the risk of having this surgery is smaller than the risk of bleeding if you do not have surgery to repair the problem.
The doctor is more likely to recommend you have surgery if the aneurysm is:
- Larger (about 2 inches)
- 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 around the time of the surgery. Your doctor is more likely to suggest this surgery if you have other more serious medical problems or if you are elderly.
Risks for any surgery are:
- Reactions to medicines
- Breathing problems
- Blood clots in the legs that may travel to the lungs
- Heart attack or stroke
- Infection, including in the lungs, urinary tract, and belly
factorsthat increase your chances of complications include:
- Congestive heart failure
- Cardiopulmonary obstructive disease (COPD), in which airflow through your lungs is decreased
- A previous heart attack
- Recurring chest pain, called angina pectoris
After the Procedure
Most people stay in the hospital for 3 to 5 days after this surgery, depending on the type of procedure you had. During a hospital stay,
- Be in the intensive care unit (ICU), where you will be watched very closely at first
- Have a urinary catheter
- Be given medicines to keep your blood thin
- Be encouraged to sit on the side of your bed and then walk
- Wear special stockings to prevent blood clots in your legs
- Receive pain medicine into your veins or into the space that surrounds your spinal cord (epidural)
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