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Aneurysm Repair

Aneurysm Repair

Abdominal Aortic Aneurysm Repair 
 

Abdominal aortic aneurysms are treated through either a traditional open surgical procedure or through a much less invasive repair known as an endovascular (meaning “within the blood vessels”) procedure. In open surgery, your surgeon will make an incision in your abdomen. The aneurysm is opened and a polyester cloth graft is sewn in place. This graft allows blood to flow to the arteries in your pelvis without filling the aneurysm.

Less invasive endovascular procedure

In the endovascular grafting procedure, your surgeon will make two incisions, one in each groin. A catheter (or tube) that contains a vascular graft is guided through a blood vessel in your leg, into your aorta and then inside the aneurysm. When the graft is positioned correctly, it is opened to the proper diameter and secured in place by inflating a balloon on the tip of the catheter. The graft is attached inside your aorta with a spring-like stent. The endovascular graft allows blood flow to your lower body while preventing any blood from filling the aneurysm.

The hospital stay is usually two to three days, and the recovery time is less than is required for open surgery. Endovascular grafting is used only in non-emergency situations. The procedure is still new and the long-term effectiveness has not been fully determined. A physician can help you determine whether endovascular grafting or the traditonal “open” aneurysm repair is appropriate for you.

Advanced vascular surgery with reduced recovery time 

Saint Raphael’s is one of only a few hospitals in Connecticut performing a new procedure to repair potentially fatal enlargements of the aorta, the body’s largest blood vessel. This new procedure, known as endovascular grafting surgery, requires only a two- to three-day hospital stay – compared with five to seven days for traditional surgery – and about two weeks of recovery. A vascular surgeon and interventional radiologist work as a team to perform the procedure, which requires just two small incisions. They then use a catheter (a thin tube), and visual imaging, to insert a synthetic piece of artery into the aorta.
 
Patients must meet specific health guidelines to undergo this surgery, including general health and certain anatomic considerations.

Carotid artery disease and stroke

You have two carotid arteries, which are blood vessels in your neck that provide oxygen-rich blood to your brain. (If you have ever taken an aerobics class, these are the arteries on which you rest two fingers to count your heart rate.) Healthy carotid arteries are open, allowing the flow of blood. But arteries can become narrowed with plaque buildup caused by atherosclerosis. Risk factors for this include high blood pressure, diabetes, smoking or eating too many fatty foods.

Bits of plaque can break off and travel through your carotid arteries to the smaller vessels in your brain. These plaque bits, called emboli, can block blood flow in the smaller vessels and cause a stroke or a mini-stroke. The goal of carotid artery surgery, called carotid endarterectomy, is to remove the plaque and reopen the artery to reduce the chance of emboli forming.

Approximately 700,000 people per year have a stroke. About 50% of these strokes are caused by hardening of the arteries, and a small percentage of those can be further contributed to carotid artery disease specifically.

What’s a carotid endarterectomy?

Carotid artery disease may require a surgical procedure called carotid endarterectomy, during which the plaque is removed, reducing the chance of stroke. Your surgeon will make a skin incision near one of the carotid arteries in your neck (the location and angle will vary from person to person). Then an incision is made in the artery itself.

During surgery, a shunt may be put in place to reroute the blood flowing through the carotid artery so that an adequate blood supply can reach your brain during the operation. A shunt is usually not necessary because of blood flow from the other carotid artery.

The surgeon will loosen and remove the plaque from the wall of your carotid artery. Afterward, the shunt, if used, will be removed, and the artery and skin incision will be closed. A small drainage tube may be placed in the incision, which will be covered by a bandage. You will then go to the recovery room for a few hours after surgery and then to our subacute vascular unit. The hospital stay is usually one to two days, and recovery time is one to two weeks.

Page last updated on Mar. 26, 2009