Endovascular Repair of Abdominal Aortic Aneurysm

The abdominal aorta is the largest blood vessel in the body. It leads away from the heart, down through the abdomen to the rest of the body. When the wall of the abdominal aorta weakens, a balloon-like swelling can develop. An Abdominal Aortic Aneurysm (AAA) can be very serious.

Endovascular repair is a preferred treatment for people with an Abdominal Aortic Aneurysm (AAA). Endovascular repair is less invasive than open surgery because it avoids a large incision in your abdomen or chest. Two small incisions in your groin are required, which means the recovery is much faster.

Why do I need an Endovascular Repair of Abdominal Aortic Aneurysm?

Some aneurysms never rupture. Some grow slowly over time. Generally, your vascular surgeon will consider a range of factors in deciding whether to refer you for surgery:

  • the size, location and rate of growth of the aneurysm

  • how complicated it is to repair

  • your overall health and family history

  • if you are experiencing any symptoms  

Treatment for Abdominal Aortic Aneurysms (AAA) depends on the size of the aneurysm and whether you are experiencing any increase in symptoms.

Small AAA (less than 5 cm in diameter)

  • Very low risk of rupture.

  • Ultrasound every 6–12 months to monitor growth and risk of rupture.

  • Control blood pressure through lifestyle changes (eg daily exercise, stopping smoking) and medication.

Large AAA (more than 5.0-5.5 cm in diameter)

  • Rapidly enlarging, causing symptoms:

    • Sudden, severe abdominal or back pain

    • Deep, constant abdominal pain

    • Problems with your feet and toes

  • A vascular surgeon may repair the AAA using a prosthetic graft through an incision in your abdomen (open surgery) or endovascular aneurysm repair (EVAR) (keyhole surgery).

What is involved in Endovascular Repair of Abdominal Aortic Aneurysm?

There are different procedures for repairing an Abdominal Aortic Aneurysm (AAA) by endovascular repair depending on where the aneurysm is located in your abdomen.

To repair an AAA located below the arteries to the kidney:

  • A thin tube (catheter) is inserted through a small incision in one or both of your groin arteries and advanced to the AAA site.

  • An expandable stent graft (a fabric-covered wire frame) is guided to the AAA site and expanded inside the artery.

  • Once in place, blood flows through the stent graft and cannot enter the aneurysm.

  • The procedure usually takes 1.5–2.5 hours and most patients leave the hospital in 1–5 days.

To repair an AAA affecting the arteries that branch off the aorta:

  • Following the same steps as above, a different type of graft is placed with more flex to align with the branching arteries and to fit your specific anatomy.

  • The procedure usually takes from 3–8 hours.

Where will my procedure be performed?

Your procedure will be performed at the hospital you agreed on with your doctor at your initial consultation.

What are the risks of Endovascular Repair of Abdominal Aortic Aneurysm?

There are risks with any surgical procedure. This includes risks associated with anesthetic and those related to your specific procedure. Your vascular surgeon will discuss all relevant risks with you prior to your operation.

What will my recovery be like after Endovascular Repair of Abdominal Aortic Aneurysm?

The recovery period depends on the type of surgery you’ve had. Healing after open surgery may take longer while endovascular treatment is less invasive.

As with any surgery, you’ll probably feel pain at the site of the incision for some time after the operation. This may be several days to a few weeks. You will be given pain medication to be more comfortable.

If you have any questions, please don’t hesitate to ask the team at Vascular Associates.