An aortic aneurysm is an abnormal enlargement, or bulging, of the wall of the aorta, the largest blood vessel in the body. As an aortic aneurysm grows, the walls of the aorta can be stretched thin, tense and weakened. If an aneurysm ruptures or tears, life-threatening internal bleeding can result.
Fortunately, if detected in time, an aneurysm may be repaired with traditional surgery and minimally invasive techniques. The best approach for repairing an aortic aneurysm is influenced by the location and size of the aneurysm, as well as your physical condition.
The objective of aortic aneurysm surgery is to prevent the aneurysm from rupturing. Surgical techniques range from a traditional, open-chest procedure to a newer, less invasive approach:
- Traditional open-chest surgery begins with a long incision in the chest or abdomen so that the affected area of the aorta is visible. The surgeon clamps the aorta above and below the diseased area. The surgeon removes the diseased area and sews a synthetic tube or graft into the aorta in place of the removed section.
Endovascular aneurysm repair or endovascular stenting is the less invasive approach. It can be used in many but not all situations. Endovascular stenting doesn’t require a large incision and results in fewer complications and a shorter recovery time. This is the preferred approach, if possible.
To perform endovascular stenting, catheters (thin, flexible tubes) are inserted through the groin, and a stent-graft — a woven tube surrounded and supported by a metal mesh which is compressed — is guided along the blood vessel to the site of the aortic aneurysm and assembled. These cases often require a specialized operating room that has high resolution x-ray equipment.
At the appropriate location inside the aorta, the stent-graft is expanded and set into place inside the aneurysm. In effect, the stent-graft assumes the pressure exerted by blood as it travels through the aorta and re-routes all the blood through this channel, which depressurizes the aneurysm and allows it to shrink in size.
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