In case that abdominal aortic aneurysm develops, the chances of ruptures increase if the condition is left untreated. The goal of treatment is to prevent aneurysm from rupturing. However, the selected approach to repair abdominal aortic aneurysm depends upon several factors including the location, size and shape of the aneurysm as well as the symptoms and physical conditions of individual patient. To surgically repair abdominal aortic aneurysm, 2 main options include an open incision (open aneurysm repair) and minimally invasive surgery called endovascular aneurysm repair.
Open abdominal surgery. Open surgery is conducted through an open cut (incision) made between the epigastric region to the groin. This approach involves removing the damaged section of the aorta and replacing it with a synthetic tube (graft) which is sewn into place. This approach is often performed in patients presenting with large ruptures, causing substantial blood loss.
Endovascular aneurysm repair. This is a minimally invasive method to treat an aortic aneurysm with superior advantages covering smaller incision, less pain, fewer post-operative complications, faster recovery time and shorter hospital stay as well as cosmetic benefits. During the endovascular aneurysm repair, the cardiothoracic surgeon first inserts a catheter into an artery through small incisions made in the groin and threads it to the aortic aneurysm. Then, using an x-ray to see the aorta, the surgeon threads a stent graft (a fabric tube supported by metal wire stents) into the aneurysm. The graft is subsequently expanded inside the wall of aorta and fastened in place to form a stable channel for blood flow. The graft reinforces the weakened section of the aortic wall to prevent the aneurysm from rupturing. However, not all aneurysms are suitable for endovascular repair. The location or size of the aneurysm in some patients may prevent a stent graft from being safely or reliably placed inside the aneurysm. In this case, open surgery might be advised.
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