Aortic Aneurysms

What is an aortic aneurysm?

When there is a weakness in the arterial wall of the aorta, abnormal swelling or a bulge in the wall of the artery can occur. This is known as an aneurysm. This most commonly occurs below the kidneys. Aneurysms are more common in males over 60, smokers and patients with a family history of aneurysm.

If you have been diagnosed with an aortic aneurysm, it is important that it is closely monitored. On average, an aneurysm will grow approximately 10% per year. Growth can be monitored using regular abdominal ultrasounds; however, once it reaches 5cm Doctor Cohen will ask that a CT Scan be undertaken to get a better look at the artery, and to help form a treatment plan.

What is the aorta?

The aorta is the major blood vessel that takes blood to the legs and is
divided into four parts:

  1.  Ascending aorta
  2.  Aortic arch
  3.  Descending aorta
  4.  Juxtarenal and infrarenal aorta.

How is it treated?

There are two main treatments for aortic aneurysm:

Endovascular

The vast majority of patients are treated via the endovascular approach. This procedure requires a catheter to be inserted through a blood vessel located in the groin. The stent graft consists of three pieces and is deployed beneath the kidneys. It looks like a pair of trousers and allows the blood to flow through the graft and not against the weakened wall. This procedure usually takes around 60 to 90 minutes to complete, with you walking post procedure around four hours, and home in two days.

There are two main kinds of treatment using endovascular techniques.

  1. Endovascular Aortic Repair, or EVAR, is the most common form of treatment for infrarenal aortic aneurysms. For a standard repair the procedure usually takes between 60 to 90 minutes, you will be discharged and returned home after a few days in hospital. For more information on EVAR and to watch a demonstration video click here.
  2. Fenestrated Endovascular Aortic Repair, or FEVAR, is a common option for the repair of an aortic aneurysm that is close to, or involving the renal arteries. This stent is usually made to suit your specific needs. The FEVAR is a more complicated operation and can take between 2 to 5 hours to complete. For more information on FEVAR and to watch a demonstration video click here.

Open Surgery

In some cases, open surgery will be required to treat the aneurysm. This will involve an incision being made in the belly and will usually take around three hours to complete. After the procedure you will go to intensive care for 24 hrs and then back to the ward. The hospital stay is around 7 to 10 days. As each patient is unique, Doctor Cohen will take the time to carefully consider and discuss the best approach for your personal situation.

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