Endovascular Repair of AAA

Why are abdominal aortic aneurysms repaired with a stent?

Endovascular repair is a preferred treatment for many people with an abdominal aortic aneurysm (AAA), and an alternative for some who do not qualify for open surgery.

Endovascular repair is less invasive than open surgery because it avoids a large incision in your abdomen or chest; only very small incisions are required. That means you are able to recover more quickly.

How is stent repair different from a standard (open) repair?

In deciding whether to recommend repair your surgeon will consider the size of the aneurysm, its location, how fast it is growing, how complicated it is to repair and your overall health.

Endovascular Repair

• Through a needle puncture or small incision in one or both of your groin arteries and guided by X-ray images, a thin tube (catheter) is inserted and advanced to the aneurysm site.
• A guide wire and an expandable stent graft (a fabric-covered wire frame) are advanced through the thin tube.
• When positioned correctly, the stent graft is allowed to expand within the artery. The wire frame pushes against the healthy portion of the aorta to seal the device in place.
• Once in place, blood flows through the stent graft and cannot enter the aneurysm.
• Some patients may also require a puncture or small incision into an artery in the upper arm.
• The procedure usually takes 1.5 to 2.5 hours and most patients leave the hospital in one to five days.

Standard Repair

• Mid line abdominal incision
• Organs are rotated out of the way to expose the aneurysm of the aorta which lies up against the back
• Control of the normal aorta is gained proximal and distal to the aneurysm
• The arteries are clamped, the aneurysm opened and a new tube is sewn into the normal arteries replacing the diseased aorta
• The procedure usually takes 3–4 hours and most patients leave the hospital in 4–7 days.

What are the risks of repair?

• There is a risk of developing lung, heart or abdominal problems during or after surgery with either approach.
• Any surgery has the risk developing an infection or bleeding issues.

If I have an aneurysm is there anything I should or shouldn’t do?

• If you have an aortic aneurysm it is important to do all you can to stay healthy.
• Stop smoking. Ask your vascular surgeon to help you find a smoking cessation program that will work for you.
• Exercise regularly.
• Carefully manage your blood pressure and cholesterol levels.
• Take a daily anti-platelet medicine (aspirin) and cholesterol-reducing medicine (statin).