Abdominal Aortic Aneurysm

Abdominal aortic aneurysm repair is indicated for patients who have a large abdominal aortic aneurysm. That means that the aneurysm is greater than 5 or 5.5 cm. in diameter. Measurement can be performed by ultrasound or CAT scan. To the right is a diagram of what an abdominal aortic aneurysm would look like.

Aneurysm Repair (Endovascular (EVAR) or Stent-Graft): This is a method to repair an aneurysm. Small incisions are  made in both groins (no stomach/abdominal incision is made) using x-ray guidance and a system of tubes and wires, the plastic tube used to replace the aneurysm is positioned inside the aneurysm. The positioning requires administering intravenous dye, not all patients are candidates for EVAR as there has to be a normal portion or aorta below the arteries to the kidneys or renal arteries and the arteries in the pelvis or iliac arteries have to be relatively free of disease.

Aneurysm Repair (Open): An  incision is made in the abdomen to replace the weakness in the aorta. This can be done in the middle of the stomach as a vertical incision or it can be done via an incision in the left flank from the incision, the bowels are pushed to the right, the aneurysm is exposed, a plastic tube is sewn into the normal blood vessel above and below the aneurysm, it allows blood flow to continue to the pelvis and legs. From the left flank incision, the bowels are out of the way, the aneurysm is exposed and the plastic tube is used to replace the aneurysm. After the plastic tube has been sewn into place, the old aneurysm is sewn over the tube and the incision is closed. Most patients spend one to two days in an ICU type area and approximately one week in the hospital. It takes two to three months to completely recover. Patients are recommended to not lift anything over ten pounds in weight for approximately 6 weeks. Once the patient has recovered from this surgery, they can look forward to a lifetime of no further symptoms from the aneurysm.