Ingalls AAA/TAA Procedures
Endovascular aneurysm repair
Interventional radiologists at Ingalls, working closely with their colleagues in vascular surgery, now offer a minimally invasive alternative to open surgical repair of abdominal aortic aneurysm (AAA) and thoracic aortic aneurysm (TAA) called endovascular stent graft repair.
Unlike traditional surgery, which involves a large incision and lengthy recovery period, endovascular repair involves small incisions in the groin and image-guided catheter placement of a stent graft to reinforce the weakened section of the aorta and prevent rupture. While not all patients are candidates for these procedures, they are highly effective alternatives to open surgery – particularly for high-risk patients with multiple medical conditions.
How Endovascular AAA Repair Works
Traditional surgery for treating AAA requires an incision over the abdomen to expose the aorta. The aneurysm is clamped off below the renal arteries and above the iliac arteries. A synthetic graft is then placed within the blood vessel containing the aneurysm, essentially removing the risk of future rupture. Since this is major surgery, it requires a hospital stay of seven to ten days, with full recovery estimated at six or more weeks.
For many individuals, particularly high-risk patients with many medical problems, major surgery is not an option, and until recently, there was no alternative.
During endovascular aneurysm repair, a small incision is made in the groin and a catheter is guided through the femoral (leg) artery to the aneurysm. Both X-ray guidance and intravascular ultrasound are used to measure the aneurysm and place an appropriately sized stent graft.
Within a few hours after the procedure, patients are encouraged to walk, and most are discharged within 24 to 48 hours. While some patients may not be candidates for the procedure, it is an excellent alternative to open surgery. Additional benefits include less blood loss, a faster recovery and fewer complications.
How Endovascular TAA Repair Works
The standard treatment for TAA is open-chest aneurysm repair, but interventional radiologists at Ingalls are able to treat many thoracic and thoraco-abdominal aneurysms with endovascular stent grafting. Using a delivery catheter and X-ray guidance, the interventional radiologist places a thoracic stent graft inside the thoracic aortic aneurysm, without the need for surgery. Once placed in the correct location, the stent graft expands to fit within the diameter of the thoracic aorta and provides a new path for the blood flow.
Patients may be candidates for endovascular stent grafting if their thoracic aneurysm is five centimeters or more in size and has not ruptured. Physical characteristics of the aorta and the aortic aneurysm itself also are important factors when determining if endovascular repair is the best treatment.
As with AAA repair, interventional repair of TAA is an effective treatment that can be performed safely, resulting in lower mortality rates, faster recovery and fewer complications than those reported for open surgical repair.