An aortic aneurysm is a pathological dilation and stretching of the walls
of the aorta. This can eventually lead to rupture and life-threatening
bleeding. We routinely screen at-risk patient populations in an attempt
to identify and treat these aneurysms before they rupture and become an
emergency. The type of aneurysm will dictate which of the following procedures
are required to repair it. Thoracic endovascular aortic aneurysm repair
(TEVAR) and endovascular aneurysm repair (EVAR) are both minimally invasive
procedures wherein a graft or stent is placed inside the artery to exclude
the dilated portion of the artery from blood flow. It essentially replaces
a short segment of the vessel and decreases the risk of subsequent rupture.
During the above surgeries, a small incision is made in your groin in
order to insert the graft. This access allows the surgeon to insert small
catheters that allow him to deploy a stent in the area of the aneurysm.
Most patients can expect go home the day after their surgery with minimal
restrictions.
Pre-op routine: Before your surgery, your surgeon will see and examine you as well as
review all pertinent labs, imaging, and tests. You will have ample opportunity
to ask questions and gain a full understanding of the nature of your disease
process and the surgery to treat that disease. You will have lab tests,
lung function tests, EKG, and chest x-ray prior to surgery. Your preoperative
instructions will be provided to you in office. Follow them, and call
the office with any needs or concerns.
Frequently Asked Questions
What are the different types of aortic aneurysms?
Aortic aneurysms can develop in different sections of the aorta. They are
commonly classified as abdominal aortic aneurysms (AAAs) or thoracic aortic
aneurysms, depending on whether they occur in the portion of the aorta
that passes through the abdomen or chest. The location, size, growth rate,
and overall health of the patient help determine the appropriate treatment approach.
What causes an aortic aneurysm?
Aortic aneurysms can develop when the walls of the aorta become weakened
over time. Risk factors may include high blood pressure, smoking, atherosclerosis,
older age, family history, and certain inherited conditions. Your healthcare
provider can evaluate your individual risk factors and determine whether
screening or monitoring is appropriate.
What are the symptoms of an aortic aneurysm?
Many aortic aneurysms cause no noticeable symptoms and are discovered during
imaging performed for another reason. When symptoms do occur, they may
vary based on the aneurysm's location and can include chest, back, or
abdominal pain. Sudden, severe pain may indicate a medical emergency and
requires immediate evaluation.
How is an aortic aneurysm diagnosed?
Aortic aneurysms may be identified through imaging studies such as ultrasound,
CT scans, or other cardiovascular imaging tests. Your provider will determine
which type of imaging is appropriate based on your symptoms, medical history,
and suspected location of the aneurysm.
When does an aortic aneurysm require treatment?
Treatment depends on factors such as the aneurysm's size, location, growth
rate, appearance, and the patient's overall health. Some aneurysms can
be monitored with regular imaging and medical care, while others may require
repair to reduce the risk of rupture.
What is the difference between EVAR and TEVAR?
EVAR, or endovascular aneurysm repair, is generally used to treat certain
aneurysms involving the abdominal aorta. TEVAR, or thoracic endovascular
aortic repair, is used for appropriate aneurysms involving the thoracic
aorta. Both procedures use a catheter to place a graft or stent within
the aorta to help redirect blood flow away from the weakened section.
Is endovascular aneurysm repair minimally invasive?
Endovascular aneurysm repair is performed through small incisions, commonly
in the groin, rather than through a large surgical opening. A catheter
is used to guide the graft or stent into position. Whether an endovascular
approach is appropriate depends on the aneurysm's anatomy and the patient's
individual circumstances.
How long does it take to recover from aneurysm repair?
Recovery varies depending on the type of procedure, the patient's overall
health, and whether complications occur. Many patients undergoing an endovascular
procedure have a shorter recovery than those undergoing traditional open
surgery. Your surgical team will provide specific instructions regarding
activity, medications, follow-up appointments, and other aspects of recovery.
What follow-up care is needed after aneurysm repair?
Follow-up care is important after aneurysm repair to make sure the graft
or repaired section of the aorta continues to function properly. Patients
may need periodic imaging and appointments with their cardiovascular care
team. The recommended schedule depends on the type of repair and individual
patient factors.
Can an aortic aneurysm rupture?
Yes. An aortic aneurysm can rupture, potentially causing severe internal
bleeding and becoming life-threatening. Sudden, severe chest, abdominal,
or back pain, particularly when accompanied by weakness, fainting, or
other concerning symptoms, requires emergency medical attention. Patients
diagnosed with an aneurysm should follow their healthcare provider's recommendations
for monitoring and treatment.
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