A graft for an abdominal aortic aneurysm is a procedure used to help prevent a rupture in the arterial wall of the aortic artery. There are two main types of surgical grafts; interventional repair and open surgical repair. Both procedures include inserting a plastic graft at the site of the arterial weakness. This allows blood flow to travel through the graft, avoiding pressure on the already weakened arterial wall.
Indication
An abdominal aortic aneurysm is a potentially life-threatening weakness in the large artery that pumps blood from the heart to the rest of the body. As blood pumps through the weakened arterial wall, it bulges outward like a balloon, increasing the likelihood of rupture and hemorrhage. The likelihood of surviving a ruptured aortic aneurysm is between 10 percent and 20 percent, according to the Society of Interventional Radiology.
Procedure
The Society of Thoracic Surgeons explains that in an open surgical repair of an abdominal aortic aneurysm, a surgeon creates an incision from just beneath the breastbone to the top of the pubic bone. The surgeon clamps off the aorta, opens the aneurysm and sews in the plastic skin graft.
An interventional or endovascular repair of an abdominal aortic aneurysm involves a less invasive method of inserting a graft. During this procedure, a radiologist makes an incision at the groin, inserts a catheter into the femoral artery and threads it into the aortic aneurysm. The radiologist passes the compressed plastic stent graft through the catheter to the aneurysm. The physician opens the stent graft, creating new walls for the blood to flow.
Recovery
After an open surgical repair, patients can expect to stay in the hospital for at least seven to 10 days, commonly in the intensive care unit. Full recovery can often take at least six to eight weeks, according to Surgical Care Associates. With an interventional or endovascular repair, patients are often discharged the day after the procedure and don't often require a stay in the intensive care unit. Full recovery often only takes two weeks.
Complications
Complications of open surgical repair include increased risk of infection, swelling, respiratory and urinary tract infections. Serious complications can include paralysis of the lower half of the body and the formation of scar tissue, which can interfere with a man's ability to ejaculate.
The main complication of an endovascular repair is the possible movement of the graft, which can cause an increased risk of rupture of the aneurysm. Patients also require lifetime follow-up appointments to ensure that the graft stays in place.
Considerations
Many factors play a part in a physician and patient determining the best type of procedure. The Society of Interventional Radiologists recommends that a person get a second opinion before choosing a procedure. Each type of grafting procedure has risks and benefits. People should discuss their options with their physician to determine which procedure will work for them.
