What are the long-term outcomes of aneurysm repair?

Mr Usman Jaffer explains that the recovery time after repairing an abdominal aortic aneurysm (AAA) mainly depends on whether you have endovascular repair (EVAR) or open repair. With an endovascular repair, the recovery time is usually quicker. You could expect to be discharged home in a day or two if there are no complications and get back to normal activities in a few days. It is very unlikely you will need to stay in intensive care. An open repair is a major surgery so you should expect to be in hospital for about a week and slowly getting back to normal activities over a period of about 6 weeks. You will probably need to stay in an intensive care or a high dependency unit at least the night after the operation.

Mr Usman Jaffer explains some of the factors that may be important to consider when deciding which operation to have for abdominal aortic aneurysm (AAA). Research from our institution shows that there are a number of factors identified by key stakeholders (patients, surgeons, radiologists, anaesthetists, intensive care doctors, peri-operative doctors) that can allow you to make a more informed decision with your doctors. These include: pre-existing medical conditions, post-operative complications, 30-day mortality, type of anaesthesia, long-term durability of operation, time to return to normal activities, post-operative pain, patient expectations, impact on carers, personalised information, professional advice, involving others (family/friends), uncertainty, how invasive the surgery is, patient journey, patient values, social factors, need for follow up, length of hospital stay, probability of intensive care admission, impact of energy levels.

This gentleman and his wife have kindly agreed to share their experience from the treatment he needed for symptomatic aortic aneurysm repair. He was admitted as an emergency due to increasing abdominal pain, which was related to expanding abdomina aortic aneurysm. He recovered well from the surgery.

Mr Usman Jaffer explains that there are two options to repair an abdominal aortic aneurysm (AAA): endovascular repair (EVAR) and open repair. Open repair is a major operation which mostly commonly involves an incision vertically down the abdomen (belly). The aorta is then found at the back of the abdomen behind the guts. The area of aneurysm in the aorta is then opened and a fabric tube is fixed inside the aorta to strengthen it. Different types of grafts are used depending on where the aneurysm is located and how far it extends.

Mr Usman Jaffer explains when it is important to consider repair for an abdominal aortic aneurysm (AAA). Evidence from trials shows that operating on small aneurysms (less than 5.5cm in diameter) has no benefit over monitoring. Generally, we would offer to repair aneurysms greater than 5.5cm.

Mr Usman Jaffer explains that abdominal aortic aneurysms (AAA) can be caused by a number of different factors. One of these factors is having a family history of aneurysms, so there is a hereditary component. But there are other causes such as atherosclerosis (hardening and narrowing of the arteries) which can happen as part of ageing and having other risk factors such as high blood pressure or smoking.