Abdominal Aortic Aneurysm Surgery is the only Way to Repair an Aneurysm.
Abdominal aortic aneurysm is dilatation of the largest artery in the body that may rupture and cause internal bleeding. The only treatment for a ruptured aneurysm is abdominal aortic aneurysm surgery. If the swelling is less than 3 cm, no surgery is required. Two types of surgeries are used to treat ‘AAA’, conventional type of open surgery or less invasive endovascular abdominal aortic aneurysm surgery. Depending on the present severity of the condition and future predictions, the doctor and patients should discuss the risks involved in a surgery compared to rupture of the aneurysm.
Risks involved in abdominal aortic aneurysm surgery
Patients suffering from prior medical issues are at higher risk. Example,
High blood pressure
Diabetes
Kidney failure
Stroke
Gastrointestinal problems
Lung disease
Patients suffering from cardiovascular disease are vulnerable to surgical complications especially in open surgery. Elderly people are at higher risk of complications due to age related issues.
If the aneurysm has increased, more than 5.4 cm in diameter following risks may develop during the abdominal aortic aneurysm surgery.
Excessive bleeding prior to and post surgery
Injury to adjacent tissues
Injury to intestine and adjoining organs
Blood clots in the legs (this might carry the blood clot to the lungs through artery track)
Numbness in legs (caused because of damage to certain nerves)
Vascular issues (difficulty in breathing)
Infection in the urinary track and lungs
Damage to the ureter
Improper blood supply to colon
Impotency (rare)
Injury to the spinal cord caused due to improper blood supply to the spinal cord
Prosthetic graft infection
Heart attack or stroke
Reaction to medicines
Most of these risks are associated with open surgery. Endovascular surgeries being less invasive poses lower risk. However, acceptance of the stent graft by the body in endovascular abdominal aortic aneurysm surgery is a major risk. Hence, patients undergone endovascular surgery requires regular ultrasounds and CT scan for 6 months to 1 years post surgery to monitor progress.
Open surgery: As the name suggests, a large cut is made in the abdomen area or on the left side of the abdomen. An anticoagulant is administered to avoid thickening of the blood and avoid formation of blood clots. Then the blood flow is redirected by clamping the arteries. The aneurysm is then physically pulled out slightly; cleaned and drained if contains any liquid. Then cylindrical shape graft is inserted and sewn in place from where the portion of the aneurysm attached to the aorta was removed. The graft is then rinsed out to remove any existing debris or air. Once the graft is in place the clamps on the arteries is removed for proper blood flow. Intravenous lines are inserted for providing fluids and monitoring progress.
Endovascular abdominal aortic aneurysm surgery: Endovascular surgery is less invasive and less risky compared to open surgery. An endovascular surgery starts by administering anesthesia and intravenous sedation. Then the doctor makes an incision in the groin area and pulls out a femoral artery. A thin tube called a catheter is inserted into the artery. Then with the aid of fluoroscopy, that is an x-ray and contrast dye the floating of the graft is monitored. Once stent graft is drifted to the place of the aneurysm either it opens up automatically or it is stretched out with help of an angioplasty inflate. Finally, the incision is sewn up. Endovascular surgery requires regular computed tomography (CT scan) monitoring for 6 months to a year post surgery.
Abdominal aortic aneurysm surgery is the only way to repair the aneurysm. Which type of surgery suits the patient best depends on the severity of the condition and complications involved. Hence, a thorough medical checkup and discussion with the doctor is advisable prior to surgery.