The best method to repair each aneurysm depends upon several factors, including the location and shape of the aneurysm as well as the physical condition of the patient.
Traditional Open Surgery
The traditional method involves making a long incision in the skin to open the chest or abdomen (depending upon the area in which the aneurysm occurs). The segment of the aorta above and below the bulging aortic section is clamped and the aneurysm segment is opened. Tubes made out of artificial material, such as polyester, are positioned inside the artery and sewn to the aorta above and below the aneurysm. This essentially replaces the aneurysmal segment of the aorta with an artificial one.
Minimally Invasive Repair: Endovascular Grafting
Instead of an open aneurysm repair, your surgeon may consider a newer procedure called an endovascular aneurysm repair (EVAR, TEVAR, FEVAR). Endovascular means that surgery is performed inside your aorta using thin, long tubes called catheters. You may be eligible for endovascular stent grafting if your abdominal aortic aneurysm has not ruptured and the aneurysm is five centimeters or larger in size.
Your surgeon will enter through small incisions in the groin, using catheters to guide and deliver a stent-graft through the blood vessels to the site of the aneurysm. X-ray guidance is used to position a graft made of artificial material to the area of the aneurysm. The graft then is expanded inside the aorta and held in place with metallic hooks and stents rather than sutures.
Cleveland Clinic Abdominal Aortic Aneurysm Treatment Outcomes
Cleveland Clinic's Department of Vascular Surgery is recognized internationally for its leadership in the repair of complex aneurysms and has published many reports concerning the early and late results of management.
With more than 1,500 patients now treated with minimally invasive aneurysm repair, the experience we offer patients requiring abdominal aortic aneurysm surgery is increasingly important. Patients undergoing this approach experience reduced operative morbidity and mortality when the procedure is performed by a skilled team. Increasingly, the minimally invasive approach is becoming the preferred method, as it reduces complications.