Endovascular AAA Repair

Abdominal Aortic Aneurysm
An abdominal aortic aneurysm (AAA) can be repaired via traditional surgery or via a relatively new non-invasive technique called endovascular stent grafting. Endovascular stent grafting is performed in a state-of-the-art endovascular procedure suite equipped with the latest imaging technology, which enables physicians to view and navigate the smallest to largest arteries in the body. The endovascular stent graft procedure brings specialist physicians from four different disciplines (cardiology, radiology, vascular surgery, and anesthesia) to the operating table to work together.

Patient Selection
Patients are selected for endovascular stent grafting if their anatomy and the type, severity, and location of the AAA are amenable for the procedure. Patients who have small, twisted, calcified, or blocked arteries may not be good candidates for the procedure. Abdominal ultrasound, MRI, and/or a CT scan may be performed to allow physicians to visualize the aneurysm and the patient’s vascular anatomy.

The Endovascular Procedure
The procedure requires a small, 2-inch incision on each side of the groin. These small incisions allow catheter access to the patient’s abdominal arteries. Through the catheter, the physician positions, places, and deploys a stented graft inside the AAA. The graft reinforces the aorta and creates a new route for blood flow, which reduces the pressure on the aneurysm to prevent it from bursting. Endovascular stent grafting is intricate work; access to the aorta is gained through narrow vessels. The physician must have precision and experience to correctly position and deploy the stent.

Advantages
The advantages of this innovative procedure are increased patient satisfaction, decreased pain, and a shorter, 1- to 2-day hospital stay.

Risks
Endovascular stent grafting is a relatively new procedure. As with other developing technologies, it does not have the 50-year success rate of traditional AAA repair surgery. Some patients have severe health problems or difficult anatomical configurations that make the procedure ineffective or impossible.


Resources

Hoag Heart Institute www.hoaghospital.org/heartinstitute/Vascular-AAA.aspx
Vascular Disease Foundation www.vdf.org/diseaseinfo/aaa/treatments.php
Endovascular Today www.evtoday.com/AAA/Endovascular AAA Repair.html