Aortic Stent Grafting

Aortic stent grafting is a differentfrom open surgery in the sense that it is less invasive than the standard open surgery for aortic aneurysm.

An aneurysm is an abnormal enlargement or bulging of a blood vessel and is the result of a section of the vessel becoming weak and is unable to withstand the pressure of blood flowing through it. The bulge will generally occur at the area of the weakened part of the vessel and will usually at the start be small and will grow to be large as the pressure continues to build. The aorta is the main artery carrying oxygen-rich blood from the heart to areas all over the body that extends from the left lower chamber (ventricle) of the heart and goes through the chest, down through the abdomen, and into the pelvis. Aneurysms in this vessel are especially troublesome because the aorta branches off and supplies blood to the brain, liver, stomach, intestines, spinal cord and other areas of the body. An untreated aneurysm runs the risk of bursting and causing severe health complications, including death.

To treat the aortic aneurysm, stent grafting is done. A stent graft is a small tube made of fabric supported by a metal mesh. The stent is designed to seal securely with the artery above and below the aneurysm strengthening the wall of the vessel and making it safe for the blood to flow through.

Procedure

Prior to the procedure, a number of diagnostic tests will be performed. These diagnostic tests allow the doctor to visualize the abdominal aneurysm and the surrounding area, and help the surgeon decide what type of stent graft is most appropriate for you. The stent graft is positioned inside the aortic aneurysm with the help of a delivery catheter; which is a long,thin, soft plastic tube. The delivery catheter contains the compressed stent graft. The catheter is inserted into an artery in the leg near the groin. Delivery catheter is inserted through the vessel into the aneurysm to guide the stent into place. Using advanced imaging methods, the surgeon directs the delivery catheter with the stent graft to the area of the abdominal aortic aneurysm. Once the stent graft is in position, the surgeon affixes it into its place and removes the delivery catheter. The endovascular stent graft is placed inside the abdominal aorta to help keep the aneurysm from bursting. This procedure does not require open-chest or open-abdominal surgery. Because it is less invasive than open surgery, the recovery time for stent grafting may be faster. X-ray, ultrasound, and anesthesia may be required during the procedure. The procedure may take 2 to 3 hours.

After surgery, the patient may have to lie flat for 4 to 6 hours to allow the leg wounds to begin healing. There may be some discomfort such as swelling of the upper thigh, numbness of the legs, nausea, vomiting, leg pain, malaise, lack of appetite, fever, constipation for one to three days. Usually, the patient can return home within a week and return to normal activities in 4 to 6 weeks

Complications that can happen after surgery include leakage of blood around the graft, graft displacement and the stent tear. Complications that are rare but serious include paralysis, rupture of the aneurysm or infection.