Patients with abdominal aortic aneurysm must be carefully watched to determine growth in the aneurysm’s diameter. If the aneurysm is large enough that the vascular expert recommends treatment to prevent rupture (rupture results in death in the vast majority of cases) there are currently two treatment options--surgical repair, and the minimally invasive endovascular stent graft.

What is the conventional treatment for abdominal aortic aneurysm?

Open surgical repair involves an incision that extends from just below the breastbone to the pubic bone. During the procedure, the vascular surgeon clamps off the aorta (which can cause a great deal of stress on the heart), cuts the aneurysm open, and sews a graft in place. The graft acts as a tunnel for blood flow, removing the pressure on the weakened aortic wall.

Why is an endovascular stent graft now considered by many the preferred treatment for an enlarged AAA?

In this procedure, the interventional radiologist makes a small incision in the groin and guides a catheter inside the patient’s body to the site of the aneurysm. A stent graft is passed through the catheter into the aneurysm where it is then opened, creating a new wall through which blood can flow. Just as with the more involved surgical procedure, the new wall takes pressure off of the weakened aortic wall. But with the interventional procedure, the patient avoids a huge incision with many sutures and avoids the stress caused by clamping off the aorta. Additionally, the interventional procedure requires about two weeks for complete recovery, as compared with six to eight weeks of recovery time for the open surgery.

Is the endovascular stent graft for everyone?

No. The stent graft must precisely fit the portion of the weakened aortic wall being treated. Because the stent graft is only available in certain sizes, not all patients are able to choose this option.

Are there follow-up issues?

Yes. The patient must be monitored following endovascular stent graft to make certain the stent graft remains in place.