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Abdominal Aortic Aneurysm Repair: The procedure, risks, complications and more

  • Posted on- Oct 14, 2016
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The aorta is the largest artery in the human body originating from the heart (left ventricle) and extending to the lower abdomen. It carries blood to the belly, pelvis, and legs. An aneurysm is an abnormal widening or bulge in the artery caused by weakening of the arterial wall. Abdominal Aortic Aneurysm (AAA) Repair is a surgical procedure involving the removal or repair of an aortic aneurysm.

Why an abdominal aortic aneurysm repair surgical procedure is performed?

An Abdominal Aortic Aneurysm Repair procedure is performed to prevent rupture and hence, haemorrhaging of the aneurysm. Additionally, if the aneurysm enlarges to the extent of causing pressure on the neighbouring tissues and organs, it is better to have it repaired as early as possible.

How an abdominal aortic aneurysm repair surgical procedure is performed?

Abdominal Aortic Aneurysm Repair is performed under general anaesthesia. Treating an aneurysm is completely dependent upon its size and location. These factors also dictate the kind of repair the medical experts will adopt.

Open Repair

  • The surgeon makes an incision through the skin, fat, muscles, neighbouring tissue, and body organs to locate the aneurysm on the artery
  • The affected artery is isolated and clamped, just above and below the aneurysm spot
  • The aneurysm is then opened to remove blood clots and plaque, and replaced with a synthetic graft
  • The graft is sewn to the healthy stumps of the artery and it is checked to ensure proper blood flow
  • The incision is closed layer by layer and finally the skin closed, with sutures or staples and bandaged

Endovascular Aneurysm Repair

  • This is a less invasive procedure performed with the help of x-ray imaging
  • It involves the insertion of a catheter through the femoral artery in the groin
  • Graft (a metal mesh stent) is deployed in the aneurysm with the help of the catheter
  • It is guided through the artery with the aid of x-ray imaging (fluoroscopy) and a radio contrast solution, injected in the blood
  • Once the stent is placed on the arterial wall with the support of hooks, the catheter is withdrawn. The skin is then closed and bandaged
  • The stent acts as an artificial lumen (hollow inside space in an artery) for blood to flow, and not into the surrounding aneurysm sac
  • Thus, the chance of aneurysm expansion and rupture is decreased significantly

Abdominal Aortic Aneurysm Repair procedure is generally performed by a vascular or a cardiovascular surgeon, assisted by an anaesthesiologist, a radiologist and a pathologist. Endovascular Repair can also be performed by an interventional cardiologist.

Preparations needed before an abdominal aortic aneurysm repair surgical procedure

  • The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient including information related to the medications that are being currently taken
  • Some medications increase a person’s chances of bleeding and it may be recommended to discontinue them for a period of time, before the procedure is performed
  • Blood tests may be performed to determine if there is a bleeding tendency or any other medical conditions that prevents the person from undergoing the procedure
  • Inform the physician if you are allergic to any local anaesthetics, lidocaine, etc.
  • Avoid application of any cosmetics, deodorant, or topical medicines on the area, prior to the procedure
  • It is advisable to quit smoking and the use of any nicotine based products, for a while, before the surgery
  • Consumption of alcoholic drinks must also be avoided for a period of time, as instructed
  • The patient must avoid eating or drinking at least 8 hours prior to the surgical procedure, depending on when the procedure is arranged
  • For persons suffering from diabetes, it is important that the blood sugar stays within the normal range if not their diabetologist may have to control blood sugar by recommending insulin or a combination of oral medicines

Diagnostic lab tests needed before abdominal aortic aneurysm repair procedure

Prior to an Aneurysm Repair, the physician may recommend any of the following tests:

Risks and complications during abdominal aortic aneurysm repair surgical procedure


Risks and complications after abdominal aortic aneurysm repair surgical procedure

  • Renal failure (if blood supply to the kidney is affected)
  • Ischemic colitis (if blood supply to the colon is affected)
  • Groin hematoma (swelling in the groin due to accumulation of blood clot)
  • Dissection (blood spreading in between the layers of the arterial wall)
  • Cardiac arrhythmias
  • Congestive heart failure
  • Migration of the stent
  • Kinking of the stent
  • Incisional hernia
  • Endoleak

Post-operative care needed after abdominal aortic aneurysm repair surgical procedure

  • Avoid any strenuous activity for 6-8 weeks
  • Always keep the surgical wound clean and dry
  • Early ambulation aids in a faster recovery
  • Use heat pad or warm compress to relieve incision pain
  • Take stool softeners to prevent constipation
  • Take medications to keep blood pressure under control
  • Complete the course of medication, and avoid non-prescription pain medication
  • Avoid sex till complete healing has taken place (under advice of the physician)

Comments

user profile image
17-02-2018 09:24 PM

I had this surgery done when I was suffering from aortic aneurysm. Execution of the process is far good.

user profile image
18-07-2017 12:50 AM

Nice information shared. It was very helpful. Will contact Lazoi in future for Sure.

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