Aneurysms

An aneurysm is a bulge in a blood vessel that results when the walls of the blood vessel weaken and become thinner and stretch, like a balloon. Ultimately, the vessel walls can become so weakened and thin that they can no longer support the force of the blood flow. In such cases, they can burst and cause serious internal bleeding.

While the Blank Vascular Surgeons also treat thoracic aneurysms , the most common aneurysms they treat are abdominal aortic aneurysms (AAA). The aorta is the main blood vessel that carries blood from the heart to the rest of the body; it extends from the chest to the abdomen, or stomach, before it branches out into the iliac arteries, which carry blood to the legs and lower part of the body.

Factors that increase the chances of developing an AAA include heredity, advancing age, smoking, and high blood pressure. Most patients have no symptoms. Some, however, feel pain in their abdomen, back or chest, or feel a pulsating or throbbing mass in their abdomen. AAA is often found during tests, such as CT scans or ultrasounds, for unrelated problems, or a patient's doctor might feel a throbbing in the abdomen during a routine exam.

If the aneurysm is small, it might be watched for a while. But if gets larger, the chances of it bursting become greater. To prevent that, a graft - a man-made, polyester tube - is inserted inside the aorta. The graft has a main tube and two smaller, lower legs that extend into the iliac arteries, which feed the femoral arteries in your thighs.

To insert the graft, the Blank Vascular Center offers patients two options, open surgery or endovascular aneurysm repair .

Open Surgery

During open abdominal aortic aneurysm surgery, the surgeon:

  • Makes an incision in the abdomen and gently moves aside some organs to reach the damaged section of the aorta.
  • Opens the aneurysm and cleans out any blood clots
  • Sews the graft to the aorta.
  • Wraps the wall of the aorta around the graft and then sews up the wall.
  • Sutures or staples the incision site closed.

The procedure takes two to four hours. Following open surgery, patients may be hospitalized five or more days. Full recovery takes up to three months.

Endovascular Aneurysm Repair

During endovascular aneurysm repair (EVAR), the surgeon, guided by X-rays:

  • Makes two small incisions near your groin to reach your femoral arteries.
  • Threads a thin, flexible tube (a catheter) into each artery.
  • Places two or three parts of the graft, a main body and two legs, into the catheters and guides them to the damaged aorta. Sheathed in plastic, the grafts are made of polyester tubes that are sewn to a frame of self-expanding, stainless steel mesh stents.
  • Positions the grafts together in the aorta and the iliac arteries below the aorta, so that they extend above and below the damaged area. After he or she releases them from their plastic sheaths or tubes, they open up to fill with blood. When both legs are connected to the main body, the graft seals off the aneurysm. The self-expanding stents hold the graft in place.
  • Removes the catheters and closes up both incisions with a few stitches.

The procedure takes one to three hours. Following an endovascular procedure, patients may be hospitalized up to three days. Full recover usually takes two to four weeks.