Aortic Aneurysm Repair With Endovascular Stent Graft

Written by Brian Krans | Published on August 20, 2012
Medically Reviewed by George Krucik, MD

What Is Endovascular Aortic Aneurysm Repair?

Aortic aneurysm repair is done to stop problems that happen when your aorta becomes enlarged or weakened. The aorta is your body’s largest artery and the descending portion sends blood to the lower half of your body.

There are two types of aortic aneurysm repair: endovascular and open aortic aneurism repair. Endovascular is much more common.

In endovascular aortic aneurysm repair, a doctor places an endovascular stent graft in the aorta to repair it. The graft is a fabric mesh tube.

Understanding Aortic Aneurysms

An aneurysm happens when the aorta stretches or balloons in one or more places and the aorta’s walls become thinner. An aneurysm is a big health concern.

An aortic aneurysm can cause:

  • loss of consciousness
  • stroke
  • shock
  • heart attack
  • death

You may have no symptom of an aortic aneurysm, but when an aneurysm affects the aorta, you may have a tearing pain in the middle of your chest or back. If your aorta ruptures you could have massive bleeding and could die.

Purpose of an Endovascular Aortic Aneurysm Repair

Your doctor will do an aortic aneurysm repair to stop the aorta from rupturing. The surgeon makes the repair with an endovascular stent graft, which reinforces the weakened spot in the aorta and keeps the aneurysm from rupturing.

An aortic aneurysm repair may or may not be an emergency. If your doctor finds that you have an aortic aneurysm, he or she may suggest you to wait to have it repaired if you have no pain or symptoms. If you have symptoms connected with the aneurysm, your doctor will schedule an appointment for the repair as soon as possible.

Risks of Aortic Aneurysm Repair

Infection and bleeding are two main risks connected with aortic aneurysm repair. You may have allergic reactions to medications, and in rare cases, you may have a heart attack or stroke.

Because the aorta is the largest artery in your body, a repair procedure carries the risk of bleeding around the graft and limited blood supply being sent to your body’s organs.

Other risks of aortic aneurysm repair are:

  • blockage at the stent
  • erectile dysfunction
  • kidney failure
  • nerve damage
  • stent slippage

If an aneurysm is 2 inches long or is growing, there are more risks in not having the repair than in having it.

Preparing for Aortic Aneurysm Repair

Before your surgery, your doctor will take your medical history and give you a complete a physical examination. Tell your doctor about all medications and supplements you are taking. Be sure to include over-the-counter medications.

Before your surgery, your doctor will examine the aneurysm with an ultrasound, echocardiography, angiography, MRI, or CT scan.

You will be given instructions about eating and drinking fluids before your surgery.

The repair will take place in a hospital. You will be given anesthesia to numb the pain of the incision site.

The Aortic Aneurysm Repair Procedure

Aortic aneurysm repair requires only a small incision in your artery. The surgeon will usually access your femoral artery, which is a branch of the aorta, by making a small incision in another part of your body, such as your groin.

He or she will first insert a wire through the incision and into your femoral artery. The wire will help guide a long thin tube, called a catheter, through the inside of the arteries to the place of the aneurysm. The catheter can safely navigate through the inside of arteries; it reduces the risk of the procedure, allows for a quicker recovery , and reduces pain.

Your arteries have no nerve endings so you should not feel any pain as the wire moves through them.

The surgeon guides the catheter to the aneurysm and puts the stent graft into place to repair the weakness. Some stents slowly release medications to help prevent blood clots and other problems after the procedure.

After the stent is securely in place, the surgeon removes the catheter, closes the incision wound, and dresses the wounds.

Following Up After the Aortic Aneurysm Repair

If you have an aortic aneurysm repair, you will usually spend two or three days in the hospital. In the hospital you will be encouraged to eat and walk, but after you leave the hospital you will be discouraged from driving, heavy lifting, and other strenuous activities until you see your doctor for a follow-up appointment.

Until your doctor removes the repair stitches, you will need to care for your wound by keeping it clean and changing the dressing.

You will have follow-up appointments with your doctor so he or she can check on the success of the surgery. You will be encouraged to change your lifestyle to prevent further problems. Changes usually include changes in your diet, exercise routine, and medication.

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