The aorta is the largest artery in the human body and carries oxygenated blood from the heart to other tissues and organs. The portion of the aorta that runs into the abdomen is called the abdominal aorta. The abdominal aorta can become weak, causing the weakened portion to expand or bulge. This is known as abdominal aortic aneurysm. This type of aneurysm may need surgery to prevent the aneurysm from rupturing and causing life-threatening complications.
Abdominal Aortic Aneurysm
Abdominal aortic aneurysm can be caused by genetic mutations, smoking, high cholesterol, obesity, high blood pressure and emphysema. Signs and symptoms of this condition include abdominal rigidity, anxiety, abdominal mass, clammy skin, vomiting, nausea, pulsating sensation in the abdomen, rapid heart rate when standing up, shock, sudden abdominal pain or sudden back pain. According to the USC Center for Vascular Care, smoking is the greatest risk factor for developing an abdominal aortic aneurysm. This condition can be diagnosed using abdominal ultrasound, aortic angiography or abdominal CT scans.
Procedure Indications
According to the Society for Vascular Surgery, abdominal aortic aneurysms that are smaller than 5 cm are monitored to ensure that they do not grow larger. This is known as watchful waiting. If an abdominal aortic aneurysm reaches 5 cm or larger, or continues to enlarge under observation, surgical intervention is required to reinforce the weak area of the artery and prevent the aneurysm from bursting.
Types of Procedures
Endovascular stent graft is a procedure used to repair an abdominal aortic aneurysm without making an incision in the abdomen. During this procedure, a surgeon uses live x-ray pictures to guide an endovascular stent graft to the location of the aneurysm. This graft repairs the aneurysm and strengthens the aorta. This procedure is much less invasive than an open surgical aneurysm repair and is a good option if open aneurysm repair is considered too risky. During a surgical aneurysm repair, an incision is made in the abdomen so that an aortic graft can be placed over the weakened area of the abdominal aorta. The graft is made of a strong synthetic material and takes the place of the weakened section of the aorta.
Risks and Complications
According to Medtronic Endovascular Innovations, a manufacturer of endovascular strent grafts, there is a slightly higher risk of aneurysm rupture when the endovascular stent graft procedure is done. The endovascular procedure can also result in blood leakages around the graft, blockage of blood flow, infection, fracture of the graft and movement of the graft from where it is placed. The open surgical aneurysm repair can cause damage to the intestines, spinal cord injuries, wound infections, bleeding after surgery, reduced circulation to the legs and kidneys or damage to the nerves. Both procedures can lead to reactions to anesthesia, breathing problems, heart attack, stroke, infection and blood clots that travel to the lungs.
Recovery
The endovascular stent graft procedure requires a hospital stay of two to three days. However, it requires more frequent follow-up imaging studies, which can help doctors determine if the graft is still in place. Periodic procedures may also be required to maintain the graft in its proper position. Open surgical aneurysm repair requires a hospital stay of four to seven days and it may take up to three months to fully recover from the procedure.
