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Endovascular Repair for Abdominal Aortic Aneurysm

Treatment Overview

Endovascular aortic aneurysm repair fixes an aneurysm in your aorta. An aneurysm is a weak or bulging part of a vein or artery. Your aorta is a large artery. It carries blood from your heart through your belly to the rest of your body.

If you don't fix this problem, your aorta could burst. This can cause death.

The procedure is called endovascular because a doctor repairs the aneurysm from the inside of the damaged blood vessel (the aorta). It's not a surgery. Local or general anesthesia might be used.

Your doctor may make small cuts in the groin area. Thin tubes, called catheters, are inserted through the cuts and into blood vessels. The doctor guides the catheters into the aorta. A man-made tube is placed in the aneurysm. This tube is called a stent graft.

After the procedure, your blood will flow through the stent graft. It will not push on the aneurysm.

You may spend 1 to 3 days in the hospital. You may be able to return to work and many of your daily activities 1 to 2 weeks after the procedure.

What To Expect

You may spend 1 to 3 days in the hospital. You can expect the cuts (incisions) in your groin to be sore for 1 to 2 weeks.

You may feel more tired than usual for 1 to 2 weeks after the procedure. You may be able to do many of your usual activities after 1 to 2 weeks. But you will probably need up to 4 weeks to fully recover. You may need to take at least 1 to 2 weeks off from work. It depends on the type of work you do and how you feel.

You will need regular tests, such as a CT scan or an ultrasound, to check for problems with the graft. You might have the test one or more times in the first year after this procedure. Then you will have at least one test each year for the rest of your life.

Be sure to tell your dentist and doctors that you have the graft in your aorta. This is important because you may need to take antibiotics before certain procedures to prevent an infection.

Why It Is Done

Repairing an aortic aneurysm is often recommended if the aneurysm is at risk of bursting open (rupturing). Aortic aneurysms that are large, that cause symptoms, or that quickly get bigger are considered at risk of rupturing.

Your doctor will work with you to decide which type of repair surgery—open or endovascular—is right for you. Your doctor will check:

  • The shape and location of your aneurysm.
  • Your age and overall health, to make sure that you are healthy enough for a surgery.
  • If you are able and willing to have the yearly tests that are needed after endovascular repair. Testing is done less often after an open repair.

How Well It Works

When an aortic aneurysm is at risk of rupturing, or bursting open, the benefits of repairing the aneurysm can outweigh the risks. Repairing the aneurysm lowers the risk of rupture and can help a person live longer. Repairing a smaller aneurysm, which doesn't have as high a risk of rupture, does not help a person live longer.footnote 1

Risks

An endovascular repair isn't an open surgery. So it doesn't have the risks or complications of a major surgery, and the recovery time is shorter. But there is a higher risk that you will need another procedure or surgery. footnote 2

About 1 or 2 out of 100 people die during surgery or within 30 days after surgery. footnote 3

Complications include bleeding, infection, and problems with the stent graft. A common complication is a leak around the stent graft.

References

Citations

  1. Filardo G, et al. (2015). Surgery for small asymptomatic abdominal aortic aneurysms. Cochrane Database of Systematic Reviews, (2). DOI: 10.1002/14651858.CD001835.pub4. Accessed April 9, 2020.
  2. De Bruin JL, et al. (2010). Long-term outcomes of open or endovascular repair or abdominal aortic aneurysm. New England Journal of Medicine, 362(20): 1881–1889.
  3. Lederle FA, et al. (2007). Systematic review: Repair of unruptured abdominal aortic aneurysm. Annals of Internal Medicine, 146(10): 735-41. DOI: 10.7326/0003-4819-146-10-200705150-00007. Accessed December 22, 2016 .

Credits

Current as of: December 2, 2020

Author: Healthwise Staff
Medical Review:
E. Gregory Thompson MD - Internal Medicine
Adam Husney MD - Family Medicine
Jeffrey J. Gilbertson MD - Vascular Surgery