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Abdominal Aortic Aneurysm (AAA) Repair

Everything you need to know about Abdominal Aortic Aneurysm (AAA) repair.

About Abdominal Aortic Aneurysm (AAA)

When the wall of a blood vessel is weakened, a balloon-like dilation called an aneurysm may develop. A common location for aneurysms to occur is in the abdominal aorta, which is an incredibly important blood vessel supplying blood to the legs and visceral organs. You can learn more about the causes and symptoms of Abdominal Aortic Aneurysm (AAA) here. Most AAAs do not produce detectable symptoms and are discovered during an evaluation, usually for some other medical condition. However, some may also be picked up during a thorough vascular exam, where the physician feels the patient’s belly for a prominent pulse/enlarged mass.

HOW ABDOMINAL AORTIC ANEURYSMS ARE REPAIRED

At Allegheny Vein and Vascular, Dr. Tahara uses endovascular (EVAR) techniques to repair abdominal aortic aneurysms. Dr. Tahara will consider the size and location of your aneurysm, as well as its growth rate and your overall health condition when determining the best way to perform the repair.

If your aneurysm is located below the arteries to the kidney, the standard method of repair involves inserting a catheter equipped with a stent graft into a groin artery access point and guiding it to the aneurysm site. Once positioned properly, a stent graft can be expanded within the artery to seal the stent graft in place and exclude the aneurysm. Once in place, blood will flow through the stent graft and will no longer enter the aneurysm.

However, a repair procedure is often more complex if the aneurysm affects one or more of the important arteries that branch out from the aorta. The procedural steps are essentially the same, but a different kind of stenting solution is required. In complex aneurysm repair, a fenestrated graft may be used to closely match your unique anatomy.

BENEFITS OF ENDOVASCULAR VS. OPEN REPAIR

While an endovascular repair has the benefits of smaller incisions, shorter hospital stay, and less down time, this comes with a tradeoff. While the size of the aneurysm sac usually shrinks following a stent graft placement, the aneurysm sac does in fact remain intact (albeit sealed off). Infrequently, the sac may continue to grow due to what is known as an endoleak. The possibility of endoleaks is why most physicians require routine duplex ultrasound surveillance following the endovascular repair of a AAA On the other hand, because an open AAA repair actually surgically removes the aneurysm sac and replaces that segment of the aorta with a prosthetic graft, there is no sac to keep growing. However, an open repair requires a large belly incision, longer hospitalization and a longer time before resuming normal activities.

WHAT YOU NEED TO KNOW PRIOR TO AAA REPAIR

AAA repair is not considered an outpatient procedure and therefore cannot be performed in an outpatient setting like Allegheny Vein and Vascular. A hospital stay of 1 to 5 days, depending on the circumstances, will be required before you can be released. Once Dr. Tahara determines the type of procedure you need, he will provide you with detailed instructions about how to prepare for the procedure during your evaluation. Dr. Tahara carefully explores your medical history during pre-op evaluation, including recent illnesses, existing medical conditions, and any allergies you have or medications you’re taking. He will also carefully explain how you should manage your regular medications, food, and drink just prior to the procedure. As a typical example, you may be told not to eat or drink anything several hours before arrival. You may also be asked to wear loose and comfortable clothing and refrain from wearing jewelry.

WHAT TO EXPECT AFTER YOUR PROCEDURE

The Allegheny Vein and Vascular nursing staff will call you about 24 hours after your procedure to check up on you. Typically, the patient will also come in for a followup visit with Dr. Tahara about a week after the procedure is completed.  From there on out, you will be scheduled for office visits and duplex ultrasound appointments as necessary.

IMPORTANT: It is vital that patients keep their followup appointments.  The reason for this is that vascular disease is not something that just goes away.  It is a process that continues, even after any necessary procedures have been performed.  Regular monitoring of your condition will be required in order to help you realize your best possible outcome for the long term.

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