How are abdominal aneurysms treated?
Very large or symptomatic aneurysms require treatment. There are two types of surgical treatments for large aneurysms.
Open surgical repair
This involves the surgeon making an incision to access the abdominal aortic aneurysm. The diseased portion of the aorta is replaced with a graft that acts as a replacement blood vessel. Open surgical repair is a proven procedure that has a good track record and acceptable risks. But it also involves a long recovery period. Average hospital stay ranges from 5 to 8 days. The time until return to normal activity ranges from 6 weeks to 3 months. As with any operation, open surgical repair has a risk of complications. You will want to discuss them thoroughly with your doctor.
"Endovascular " means "inside or within a blood vessel"—and that is exactly how a small fabric tube that has metal stents attached to the fabric, called a stent-graft, is introduced into your body and moved into place. First, small incisions are made in each groin to get to arteries that carry blood from the aorta. The surgeon then moves the stent-graft up through these arteries until it is opened inside the diseased portion of aorta. The stent-graft reinforces the weakened part of the vessel from the inside and creates a new channel through which the blood flows, eliminating the risk of rupture. This procedure usually takes 1 to 3 hours and patients typically leave the hospital in 1 to 2 days. Return to normal activity ranges from 2 to 6 weeks. Like any medical procedure, endovascular repair has a risk of complications. It also involves regular routine follow-up visits with your doctor to evaluate the stent-graft. These regular follow-ups are extremely important and will require CT.
If you have a small aneurysm, your doctor will ask you to come back every 6 to 12 months for a CT or ultrasound to measure the size of your aneurysm and to review any other symptoms you may have. If surgery is recommended, you will need a comprehensive medical evaluation prior to your surgery. This may include a stress test and cardiology visit.