Open Aneurysm Repair
This is the standard approach to repairing aneurysms and requires a long incision. During an open repair, our surgeon removes the weakened part of the aorta and sews an artificial tube-shaped artificial graft into place to allow proper blood flow. Depending on the case, patients typically spend a few days in the hospital and fully recover within six weeks to three months.
In open repair, our surgeon accesses the aneurysm through a long abdominal incision and sews the artificial graft into place to maintain proper blood flow.
If your aneurysm ruptures, or breaks open, it can cause life-threatening bleeding inside your body. If your aneurysm is small, or slow-growing, your health care provider may suggest watching it closely without treatment at first. If the aneurysm reaches a certain size, however, the risk it will rupture increases. You may need to have it repaired.
During open or surgical repair of an abdominal aortic aneurysm, your doctor will make a large incision in your belly to reach your aorta. Your surgeon cuts open your aneurysm, and sews a graft made of strong material into place.
Before the procedure: Before the procedure, you may have a physical exam, blood tests, and certain heart tests. You'll be asked to not eat or drink for at least eight hours before your appointment. Tell your health care provider about all medications and supplements you take, and if you have any allergies.
Your health care provider will explain what happens during the procedure. He or she will also talk with you about any risks or complications that may happen. This is the time to ask any questions you have about the procedure. You'll be asked to sign a consent form that gives your health care provider permission to do the procedure. Read the form carefully, and ask questions if anything is not clear.
What to expect: You are given general anesthesia to make you sleep through surgery. Your surgeon makes a long incision in your belly to reach the aneurysm. The surgeon places a clamp on the aorta, above and below the site of the aneurysm. This temporarily stops the flow of blood. Your surgeon cuts open your aneurysm, and sews a graft made of strong material into place.
Your surgeon removes the clamps, and sews the aorta back together. The surgeon will close the incision with staples, or stitches. This surgery may take three to six hours. You can expect to stay in the hospital for a week, or longer, after your surgery.
After the procedure: For the first few days after your surgery, you will be in the intensive care unit, or ICU. Tubes will give you nourishment, help you breathe, and drain fluids from your body. As you heal, your health care providers will gradually remove the tubes. During this time, nurses and specialists will help you care for your incision, and start walking. You'll also get medication to control pain.
Once you're home from the hospital, follow all instructions from your health care provider about the care of your incision, your medications, and your return to activity. Make sure to keep all your follow-up appointments. Don't be surprised if it takes you several months to feel fully recovered.
Things to remember: Large or fast growing aneurysms are at risk of rupturing, and need treatment. Your surgeon will repair the aneurysm by replacing it with a graft. It may take several months before you feel fully recovered from surgery.
What we have learned: During open repair of an aneurysm, your surgeon cuts away the aneurysm and replaces it with a graft. True or false? The answer is true. A graft made of a strong material is sewn into the aorta, to replace the damaged area of the blood vessel. Small or slow growing aneurysms need surgical repair. True or false? The answer is false. Your health care provider may suggest watching and waiting before recommending surgery.
Endovascular Aneurysm Repair
Unlike traditional surgery which involves a large incision and lengthy recovery period, endovascular repair uses small incisions in the groin and image-guided catheter placement of a stent graft to reinforce the weakened section of the aorta and prevent rupture. These options are highly effective alternatives to open surgery for abdominal aortic aneurysms and thoracic aortic aneurysms, especially for high-risk patients with multiple medical conditions.
Endovascular means the treatment is done from within the blood vessel. Our physician inserts a long, thin catheter into a vessel in the groin and then threads it up into the aorta. A small, flexible tube — called a stent or endograft — is guided through the catheter and inserted into the aorta to strengthen it. These procedures are performed in our state-of-the-art endovascular suite that is equipped with the latest imaging technology.
In an endovascular aneurysm repair, the artificial stent graft is inserted into an artery through a catheter and is then placed within the aorta to reinforce the vessel walls.
Because endovascular repair does not require large incisions, the hospital stay is only one to two days and recovery is much quicker than open repair. Patients who undergo endovascular aneurysm repair will need regular follow-up visits for CT imaging exams to make sure that the graft is working properly. Within a few hours after the procedure, patients are encouraged to walk, and most are discharged within 24 to 48 hours. Additional benefits include less blood loss, a faster recovery and fewer complications. While endovascular repair is a good option for many people, it is associated with a greater need for maintenance procedures than open aneurysm surgery.
The ascending aorta begins at your heart and arches toward your back. The thoracic aorta travels down along your spine toward your belly. The abdominal aorta starts near your kidneys and ends in your pelvis. There, it divides into two arteries that go down your legs.
An aortic aneurysm is a weak spot in your aorta that bulges or balloons outward. Aortic aneurysm is a serious medical condition. An aneurysm that ruptures or tears can cause uncontrolled bleeding inside your body and death.
If your aneurysm is small or slow growing, your health care provider may suggest watching it closely. But once your aneurysm reaches a certain size, the chances that it will rupture increase. And you'll need to have it repaired.
Depending on the size and location of your aneurysm, you'll either have open surgery or an endovascular repair. An endovascular repair uses two small incisions in your groin. This procedure may be recommended if you are older or have other health problems that would make recovery from open surgery more difficult.
Before the procedure: Your provider will explain what happens during an endovascular repair. He or she will also talk with you about any risks or complications that may happen. This is the time to ask any questions you have.
You'll be asked to sign a consent form that gives your health care provider permission to do the procedure. Read the form carefully. And ask questions if anything is not clear.
Your provider will also give you instructions about how to prepare for your surgery. Don't eat or drink anything after midnight the day before your surgery. Tell your health care provider about all of the medications and supplements you take and if you have any allergies. Ask your health care provider ahead of time if there are any medications you should stop taking before your surgery.
What to expect: You're given medication to help you relax and to prevent pain. You may be given general anesthesia to make you sleep. Or you may have epidural anesthesia. This medication blocks the pain in the area where the surgeon will work. An IV line is put into a vein in your arm or hand to supply fluids and medications.
Once you are asleep or the area is numb, your surgeon makes a small incision in your groin. He or she then places a thin, flexible tube called a catheter into an artery in your leg. He or she will guide the catheter to the aneurysm with the help of special X-rays.
Your surgeon uses the catheter to place the graft inside your aneurysm. A thin metal brace called a stent is expanded inside your artery. This holds the graft in place. The graft and stent reinforce the weakened area. Over time, your aneurysm may shrink.
After the procedure: After the procedure, you'll be taken to your hospital room where you will be closely watched. When your health care provider says it's OK to leave the hospital, you will need to have an adult family member or friend drive you home. Generally, an endovascular repair requires a much shorter hospital stay.
Once you're home from the hospital, follow all instructions from your health care provider about the care of your incision, your medications, and return to activity. Because your surgeon doesn't remove the aneurysm during an endovascular repair, you will need to have your aneurysm checked on a regular basis. There is still a small chance that your aneurysm will continue to grow or rupture. It's also possible for the graft to move.
Things to remember: Endovascular aneurysm repair uses catheters and small incisions to place a stent graft inside your aneurysm. The graft is permanent. Even after your aneurysm is repaired, you will still need regular follow-up testing.
What we have learned: Endovascular aneurysm repair requires a large incision in your chest, true or false? The answer is false. This procedure uses two small incisions in the groin.
The graft is put in place temporarily until another procedure can be done, true or false? The answer is false. The graft is permanent.
Hybrid Aneurysm Repair
For aneurysms that cannot be repaired through endovascular techniques alone, our vascular surgeons also offer hybrids repairs — featuring a combination of endovascular stenting and open repair. Often, hybrid procedures can be custom designed for the patient in an effort to decrease size of the incision and duration of the procedure in order to improve recovery and ensure the best possible outcome.