How are TAA & AAA treated ?
How do doctors treat an aneurysm ?
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 treatments...
- Open Surgical repair
- Endovascular repair
The goal of all treatments is to prevent the aorta from bursting.
What is 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 2 to 4 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 5 to 9 days in the hospital. Many patients are unable to eat normally for 5 to 7
days after the surgery. The overall recovery period can last upto 3 months.
As with any medical procedure, open surgical repair has a risk of complications. Discuss these
with your doctor
The traditional treatment for aortic aneurysms has been suergery, where via an incision in the chest or the abdomen, the aneurysmal segment is replaced using a vascular graft (tube made of cloth). However surgery in this group of patients is associated with risks and complications. Hence a minimall invasive procedure such as endovascular stent grafting can be performed to treat these aneurysms.
Here through a small hole in the groin arteries, a specialized device, known as an aortic stent graft is introduced into the artery, and this prevents the flow of blood into the aneurysm.
An aortic stent graft is a device made up of stents covered by a surgical vascular graft; this can be introduced through the artery and placed across the aneurysmal segment. The stents act as anchors and the vascular graft directs the blood away from the aneurysm.
Depending on the location of the aneurysm in relation to the branch arteries, combination treatment known as hybrid procedures can be performed. Here a less risky surgery is done and in the same sitting an endovascular graft is inserted. This is to preserve blood in the main branch arteries to the vital organs of the body and also treat the aneurysm.
If suergery is contraindicated then for abdominal aorta aneurysm where the aneurysm involves the intestine and renal arteries, a highly specialized procedure known as fenestrated stent grafting can also be performed.
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 repir 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 4 to 6 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. There is a also a possibility that additional treatment or surgery may be required after the initial endovascular repair.
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 advantages and disadvantages with your doctor.