What is endovascular stent graft abdominal aortic aneurysm repair?

Vascular specialists can repair aortic aneurysms with endovascular stent grafts in many patients including those whose overall health makes open surgery too dangerous. During the procedure they insert a catheter into an artery in the groin and, using x-ray guidance, thread the catheter to the damaged area of the aorta. Within the catheter is a stent graft, a tube made of a special synthetic material, that can expand as it is released from the catheter. At the aneurysm (or dissection) the stent graft is expanded so that it attaches to the aorta above and below the area of disease thereby "bridging or re-lining" the damaged portion of the aorta. The stent graft provides a reinforced channel for the blood to flow through, reducing the pressure on the damaged area of the artery and helping to prevent a rupture. Patients generally go home the following day.

Traditionally most aneurysms were repaired with open surgical methods. Today, many abdominal aortic aneurysms can be repaired via minimally invasive techniques using stent grafts. This is done by Vascular specialists who work through the femoral arteries (groin blood vessels) and use X-ray guidance and contrast dye to help position a stent graft, which has fabric and a metal scaffold support, across the weakened area of the vessel. The stent graft is allowed to open below the renal arteries and effectively bridges the abnormal segment of the blood vessel and re-inforces this area so that there is no pressure against the weak segment of the vessel.

This procedure can be done under local or general anethesia and most patients go home after a 1-2 day stay in the hospital. Patients do require follow up with CT scans after this procedure to ensure that a proper seal remains in place.

Mark J. Russo, MD
Thoracic Surgery (Cardiothoracic Vascular)

An endovascular stent graft repair is a treatment for aneurysms of the abdominal aorta. It is similar to the approach used for a cardiac catheterization of the coronary arteries. This procedure requires only small incisions in the groin. Then the surgeon inserts a catheter through the femoral artery in the groin and with the use of x-ray guidance and specially-designed instruments, the aneurysm can be repaired from inside the aorta by inserting a tube, called a stent-graft. This is possible because the tube, or stent graft, is delivered through the catheter in a collapsed state and then expanded at the site of the aneurysm. The tube replaces and reinforces the diseased aortic wall, ensuring continuity of blood flow while preventing further expansion of the aorta, aortic rupture, and/or aortic dissection.  . 

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