Treatments of Abdominal Aortic Aneurysm
How do doctors treat an AAA?
When an aneurysm is small, your doctor may recommend periodic checkups to monitor it. If an aneurysm is larger, or is rapidly growing, it has more risk of bursting. If your doctor thinks there is a risk the aneurysm may burst, he or she may recommend treatment. There are two types of treatment for AAA:
The goal of all AAA repair is to prevent the aorta from bursting.
Important Note: Not every patient is a candidate for endovascular repair. Open surgical repair and endovascular repair both have advantages and disadvantages based upon each patient’s condition and needs. Discuss the advantages and disadvantages with your doctor.
What is an open surgical repair?
In this approach, surgery is performed to repair the section of the aorta that has an aneurysm. To reach the aneurysm, a doctor makes a cut through the abdomen or the side of the patient. The doctor repairs the aorta by replacing the aneurysm section with a fabric tube called a “graft.”
The graft is sewn into place and acts as a replacement blood vessel. The blood flow through the aorta is stopped while the graft is put in place. The surgery takes about two to four hours to complete.
Open surgical repair is a proven medical procedure that works. However, it also has a long recovery period. Patients usually stay overnight in the intensive care unit, and stay another five to nine days in the hospital. Many patients are unable to eat normally for five to seven days after the surgery. The overall recovery period can last up to three months.
As with any medical procedure, open surgical repair has a risk of complications. Discuss these with your doctor.
What is an endovascular repair?
Endovascular repair is relatively new. Endovascular means “inside or within a blood vessel.” Instead of making a large incision in the abdomen, the doctor makes a small cut near each hip (near the crease between the abdomen and thigh) to get to the femoral arteries (blood vessels).
Through these small cuts, a graft (fabric tube) is inserted into the arteries and positioned inside the aorta. The endovascular graft seals off the aneurysm. The graft makes a new path through which the blood flows. The graft remains inside the aorta permanently. Endovascular repair typically takes one to three hours to complete.
Because there are smaller cuts than those in open surgical repair, endovascular repair may result in less discomfort, shorter hospital stay and faster recovery. Patients may have a hospital stay of only a few days. They can usually return to normal activity within four to six weeks after the procedure.
As with any medical procedure, endovascular repair has a risk of complications. Endovascular repair also requires routine follow-up visits with your doctor. Tests are done to evaluate the procedure and monitor success of the treatment. Refer to the follow-up section for more information. There is also a possibility that additional treatment or surgery may be required after the initial endovascular repair.