Aortic Aneurysms

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The aorta is the largest blood vessel in the human body (about 2 cm wide). The aorta carries oxygen-rich blood from the heart to all parts of the body. 

 

The aorta runs through the chest and abdomen. The part in the chest is called the thoracic aorta. The part in the abdomen is called the abdominal aorta.

 

In the lower abdomen, the aorta splits into two smaller blood vessels that carry blood to the legs.

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An aneurysm is a bulge, or balloon-like swelling, on the wall of a blood vessel. When this is found on the aorta, it is called an aortic aneurysm.  Most people do not know that they have an aneurysm. Aortic aneurysms are called ‘silent’ because they rarely cause any symptoms until they rupture. Most are found during tests (such as ultrasound, CT scan or MRI) that are done for other reasons. We recommend that your close relatives be tested for aneurysms.

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An aortic aneurysm can be dangerous because the walls of the aorta may get so weak or thin that they burst (rupture) and bleed. A ruptured aneurysm causes serious internal bleeding, which can cause death quickly without proper treatment.

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Open Aortic Aneurysm Repair

 

During an open repair, the surgical team:

• makes an incision in the abdomen and at times in the groins  

• gives you an anticoagulant (blood thinning medication) and then stops the blood flow through the aorta

• opens the section of the aorta affected by the aneurysm

• sews a durable, fabric tube (graft) into place, connecting the healthy ends of the aorta

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Endovascular Aortic Aneurysm Repair

 

EVAR is done through the blood vessels in your groin (femoral arteries). To get to the arteries, your surgeon may make:

• small incisions (5 to 7 cm) in both groins – open access

• small punctures or holes in both groins – percutaneous

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The surgeon inserts long wires and catheters (thin plastic tubes) into the arteries, up into your aorta to the aneurysm. X-ray images guide the surgeon in placing the stent graft in the correct location between two healthy portions of the aorta. When the correct position is confirmed, the stent graft is expanded and held in place by small hooks. The stent graft seals off the aneurysm.

 

At the end of surgery, dye is added to the blood to confirm the location and to make sure there are no leaks around the stent graft. In time, the aneurysm ‘sac’ should shrink around the graft.