Currently, there are two treatment options for AAA: endovascular stent graft repair and open surgical bypass.
Endovascular Repair
This minimally invasive technique is performed by NCVI Interventional Radiologists and Vascular Surgeons, often working together and using fluoroscopic imaging guidance. For the procedure, small incisions are made in the groins and catheters are passed into the femoral arteries and directed into to the aortic aneurysm. Through the catheters, a stent graft (also called an endograft) is advanced through the aneurysm. The stent graft is then expanded like a coiled spring to hold tightly against the wall of the aorta. The stent graft is like a new lining for the inside of the aorta. The device seals in the aorta above and below the aneurysm diverting blood through the device, away from the weakened aneurysm wall.
After placement, blood flows through the stent graft which decreases the pressure on the weakened aortic wall and significantly reduces the risk of aneurysm rupture. This is less a invasive method of aneurysm repair as compared with traditional surgery. Mortality, blood loss and hospital length of stay is typically less with stent graft repair than with open surgery. Patients are typically in the hospital for one to two days and are back to full activity typically within two weeks. The stent graft procedure is not for everyone, though. About one third of patients will not be candidates for stent graft repair because of anatomic features. In addition persons undergoing endovascular stent graft repair require life long surveillance with annual CT scans because a small percent of stent grafts can shift or migrate over time requiring reintervention. Stent graft technology is limited by the size and shape of the aneurysm. The stent grafts are made in certain sizes, and the patient's anatomy must fit the graft, since grafts are not custom-built for each patient. A CT Angiogram (CTA) of the aneurysm is typically performed to determine if the size and shape are suitable for stent graft repair.
In order to determine if you are a candidate for endovascular stent graft repair of your AAA ask for a referral from your doctor, or call the specialists of NCVI directly for a consultation.
Surgical Repair
The other option for treatment of abdominal aortic aneurysms is open surgical repair, typically by a vascular surgeon. This procedure typically involves a long incision in the abdomen so the surgeon can reach or expose the aneurysm. The surgeon makes an incision in your abdomen and replaces the weakened segment of the aorta with tube-like replacement called a graft. The grafts are typically made of a strong and durable plastic material similar in size and shape of the normal aorta. Once inserted, the plastic tube takes the place of the weakened aorta. Hospital stay is typically 5 to 10 days. Depending upon your circumstances, you may also require 6 weeks to 3 months for a complete recovery. More than 90 percent of open aneurysm repairs are successful for the long term.
