Endovascular aneurysm repair
Because aortic aneurysm repair is a major operation with significant death rates in those patients at high risk of open surgery (heart, lung and kidney disease), a method of repairing aortic aneurysms under x-ray control was developed.
The operation is performed by cuts in the groins and passing the graft up the arteries into the aorta, inside the aneurysm. The graft cannot be stitched into place but is held in by specially designed metal 'springs' (stents). The 'graft stent' combinations look like this:
Because the graft is made of thin material, it is supported by the metal stents as shown above.
The following drawings show how the graft is positioned in the aorta under x-ray control. The picture on the right shows how the graft is held in place with the stents.
Not all patients are suitable for this procedure. The anatomy of the aneurysm has to be just right. This may be less of a problem in the future as grafts with side holes and grafts for the bowel and kidney arteries are developed and refined.
Recent evidence suggests that in the short term this procedure is as good as if not better than the open operation. This concerns the chances of death and other complications related to the operation. However, the long term results are not yet available. We do know, however, that these grafts have to be monitored on a regular basis and approximately 25% will need further intervention of some sort within 3 years. Furthermore, there is still a 1% per year risk of rupture of the aneurysm.
Because of these problems and uncertainties I cannot recommend this procedure to all patients.
Press 'BACK' on your browser