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What are the management options for Abdominal Aortic Aneurysms?
Management StrategiesMedical ProceduresMonitoring and Evaluationaneurysmopen repairstent graftx-rayaortatummy
Mr colin bicknell
Mr colin bicknell

What are the management options for Abdominal Aortic Aneurysms?

Mr Bicknell explains that there three options to manage an AAA. First, we can do nothing and just keep it under surveillance which is suitable for small aneurysms. If they are larger and at risk of rupture, the two treatment options are endovascular (keyhole) repair and open surgery.

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In terms of management, there are three management options. The first one is to do nothing. This is suitable for small aneurysms. If they're three, four, five centimetres in size, the risk of rupture is low and keeping these patients on a surveillance program is the safest way to manage them. If they reach a large diameter and are at risk of rupturing, there are two treatment options. One is to reline the aorta with a stent graft under x-ray guidance and the other one is the standard traditional repair of an open repair which is a cut alongside the tummy to expose the aneurysm, clamping the aorta above and below the aneurysm and then directly repairing the aneurysm by sewing in a fabric tube.

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Mr colin bicknell
Mr colin bicknell

Open repair for Abdominal Aortic Aneurysms

Mr Bicknell explains that open surgery is one of the main treatment options for abdominal aortic aneurysms (AAA). He explains the steps of the procedure, which involves a large cut in the abdomen. When the aorta is exposed, it is clamped above and below the aneurysm. The aneurysm is then opened up and a fabric tube is sown in. It is a major operation which requires a short stay in high dependency or intensive care unit, around 7-10 days in hospital, and a few weeks or months to recover. The short-term complications are higher than the endovascular (keyhole approach). But the main advantage is that the repair is usually more long lasting.

Open repair for Abdominal Aortic Aneurysms
Mr colin bicknell
Mr colin bicknell

Endovascular repair (EVAR) for Abdominal Aortic Aneurysms

Mr Bicknell explains that endovascular repair (keyhole surgery) is one of the main treatment options for abdominal aortic aneurysms (AAA). It involves a medical device called a stent graft. A small cut is made into the groin, and the stent graft is then fed up under X-ray guidance into the aorta. The main advantage over open repair is that there is less trauma, less complications shortly after the operation, and patients can usually go home within a day or two. But, in the long term, there can be leakage around the stent graft into the aneurysm (endoleak), which means there is a higher chance of having further procedures. This also means that you will need more regular follow up.

Endovascular repair (EVAR) for Abdominal Aortic Aneurysms