Endovascular Thoracic and Abdominal Aneurysm Repair
The surgeons at PinnacleHealth Cardiovascular Institute treat many thoracic and thoracic abdominal aneurysms using a minimally invasive procedure called an endovascular stent graft.
A thoracic aortic aneurysm, is an abnormal bulge in a weakened wall of the aorta in the chest. This condition can cause a number of symptoms which are often life-threatening. It is important to have a thoracic aortic aneurysm diagnosed and treated as quickly as possible. Traditional treatment for a thoracic aortic aneurysm is an open-chest surgery. The surgeons at PinnacleHealth Cardiovascular Institute now treat many thoracic and thoracic abdominal aneurysms using a minimally invasive procedure called an endovascular stent graft.
What is an endovascular stent graft?
Endovascular means that surgery is performed inside your aorta. The surgeon uses a thin long tube called a catheter inserted through an incision in the groin. The catheters are used to insert a stent-graft through the blood vessels to the site of the aneurysm.
The stent reinforces the weak spot in the aorta allowing the blood to pass through it without pushing on the aneurysm.
What are the benefits of endovascular repair?
Endovascular repair offers the benefits of minimally invasive surgery which is less painful, allows for a quicker recovery and has a lower risk of complications compared to open surgery
Who would benefit?
You may be eligible for endovascular stent grafting if your thoracic aneurysm has not ruptured and the aneurysm is 5 centimeters or more in size.
Your cardiologist can determine if aortic aneurysm repair is the best treatment by performing one or a combination of imaging studies, which may include:
- High resolution, computed tomography (CT) scan
- Magnetic resonance imaging (MRI)
- Angiography (an x-ray of the blood vessels)
- Transesophageal echocardiography (TEE)
- Intravascular ultrasound
What happens during endovascular stent grafting?
Your surgeon will make small incisions in the skin above the femoral artery (the large artery that supplies blood to each leg) in the groin. A guide wire is then threaded through the artery beyond the area of the thoracic aneurysm.
Using X-ray guidance, the surgeon inserts the stent over the guide wire. Once the graft reaches the thoracic aneurysm site it expands like a spring to fit against the walls of the aorta on either side of the aneurysm, and delivers blood flow through the weakened section.
The blood can then flow through the graft, avoiding the aneurysm. Over time, the aneurysm typically shrinks due to the blood pressure being diverted.
What are the risks of endovascular repair of thoracic aneurysms?
Although endovascular surgery reduces recovery time to a few days, there are still potential risks. The possible complications of endovascular repair include:
- Leaking of blood around the graft
- Movement, or migration, of the graft away from its initial placement
- Stent fracturing
How long will it take to recover from an endovascular repair of a thoracic aneurysm?
Your hospital stay following endovascular stent grafting is usually 2 to 3 days. While your recovery will take less time than recovering from open-chest thoracic aneurysm surgery, the early restrictions are similar and include:
- No driving until approved by your physician (usually within 1-2 weeks after the procedure, and no longer taking pain medication)
- No baths until the groin incisions heal; showers and sponge baths around the incision are permitted
- Avoid lifting more than 10 pounds for approximately 4 - 6 weeks after the procedure
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