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Aortic Aneurysm Repair: Is Catheter-Based Treatment Right for You?

Your aorta is your lifeline. It carries blood from your heart to your body. Because your aorta is so important, knowing the signs of possible problems is also important.

One problem to be aware of is an aortic aneurysm — a bulge in the aorta. This bulge can be life-threatening, which is why treatment is essential.

While there are various treatment options for this condition, catheter-based repairs have shown promising results in terms of effectiveness and quick recovery. Here’s what you should know about catheter-based aortic aneurysm repair.

Source: July 2015 study of nearly 80,000 patients who had aortic aneurysm procedures

Aortic Aneurysms 101: The Short Version

Arteries are a type of blood vessel. They function like pipes carrying oxygen-rich blood throughout your body. An aneurysm is a balloon-like bulge that forms in an artery because the artery wall is weak.

Typically, arteries have thick walls to withstand normal blood pressure. However, an aneurysm can make withstanding the pressure more difficult and increase the risk of the artery wall rupturing.

This may be because of a disease or injury, or it may simply be something you are born with. Certain lifestyle habits — like smoking — can also be the culprit. Sometimes the cause is completely unknown.

Aortic aneurysms form in the aorta — the main blood vessel that feeds blood from your heart to all of your organs and tissues. There are two types of aortic aneurysms.

  1. An abdominal aortic aneurysm (AAA) is when the aorta, which supplies blood to the abdomen, pelvis, and lungs, balloons out.
  2. A thoracic aortic aneurysm (TAA) is a ballooning of the portion of the aorta that passes through the chest.

If either type of aneurysm ruptures or dissects (splits the artery wall), this can lead to internal bleeding, either within the body or the artery wall. This lack of circulation can lead to weakness or paralysis in areas of the body or failure of any organs that don’t receive enough blood. Untreated ruptures are a medical emergency, and only an estimated 50% make it to the hospital for treatment, while up to 50% do not survive the repair.

Symptoms to look out for are:

  • Chest and jaw pain, either stabbing or radiating
  • Fainting
  • Difficulty breathing
  • Sudden weakness on one side of the body
  • Clammy skin
  • Nausea
  • Vomiting
  • Shock

While aortic aneurysms can be dangerous, early diagnosis and treatment go a long way toward lowering the risk.

Treating Aortic Aneurysms

Aortic aneurysms can be treated with medicine or surgery. Depending on the size and location of the aneurysm, your physician may also choose to simply monitor it to ensure it isn’t growing. Medicine may also be prescribed either before or instead of surgery to lower your blood pressure, relax your blood vessels, and ultimately lower the risk of a rupture.

However, if the aneurysm is growing quickly or is at risk of rupture, your physician may recommend surgery. Your physician may also recommend surgery because of stenosis — the narrowing of the inside of the aorta.

There are two major types of surgery for an aortic aneurysm: Open surgery or catheter-based surgery.

In open abdominal or chest repair, your physician will make an incision in the abdomen or chest to access the aneurysm site. The aneurysm is then completely removed and a graft is used to replace that section of the aorta. This surgery will often require about a month of recovery.

Depending on the size and location of the aneurysm, your physician may recommend the second type of aortic aneurysm treatment, catheter-based endovascular repair.

Catheter-Based Aortic Aneurysm Repair: 3 Key Terms

  1. Endovascular Repair (EVAR): A catheter-based procedure to repair a major blood vessel
  2. Stent graft: A device made of metal mesh covered with fabric that is inserted into the artery to help strengthen the artery wall
  3. Catheter: A small tube inserted into the artery to bring the stent graft to the aneurysm locations

Catheter-Based Aortic Aneurysm Repair: In 5 Steps

  1. This procedure is usually done using general anesthesia, where an anesthesiologist will administer medicine through an IV to make you completely unconscious.
  2. Your physician will insert a catheter (small tube) into an artery in your groin and use X-ray imaging to guide it to the aneurysm.
  3. Your physician will use the catheter to place a stent graft in your aorta (device used to strengthen the artery wall).
  4. The graft will be expanded in the aorta and fastened into place to allow for proper blood flow and to reduce the risk of the aortic wall rupturing.
  5. There may be some discomfort or pain when you awaken, but you will be able to return to normal activities shortly after the procedure.

(Source: National Heart, Lung, and Blood Institute; Society for Vascular Surgery)

Why Catheter-Based Therapy is a Promising Treatment Option for Aortic Aneurysm Repair?

Catheter-based aortic aneurysm repair has been around since the early 1990s, and data in recent years has continued to show it is a safe and preferred treatment option for many patients with aortic aneurysms. In fact, outcomes have continued to improve over time. Today, catheter-based therapies account for almost 50% of aortic aneurysm repairs in the U.S.

This procedure is less invasive and typically involves a shorter recovery period than traditional surgery. This procedure is also often a safer option for older patients and patients who have other chronic conditions.

Studies suggest that catheter-based repair also has more promising short- and long-term results than open surgery. The procedure tends to have lower rates of post-surgical complications — such as pneumonia — and patients are usually able to return home sooner.

Before and After Catheter-Based Aortic Aneurysm Repair

Your physician may suggest that you stop blood thinners before the procedure. You should also talk to your physician about smoking cessation programs. Quitting smoking can help prevent complications.

Ask your physician about how long you’ll need to wait before returning to normal activity and what will be the next steps for monitoring your aneurysm.

What Risks Are Involved?

As with any procedure, catheter-based aortic aneurysm repair is not entirely risk-free. Risk factors include potential bleeding or infection at the puncture site. Serious risks can include stroke, weakness in the legs, or heart attack following the surgery. The good news is these serious risks tend to be rare.

Knowing the signs of complications — and communicating any concerns you may have to your physician — are key to preventing serious issues before, during, and after recovery.

Special Concerns for Women

Because estrogen can offer some protection against them, aortic aneurysms are less common in women.

Some studies also suggest women who are on hormone replacement therapy may have a lower risk of ruptures, although the exact role of hormones in relation to aneurysms is still unclear.

This doesn’t mean that women are immune from developing them. Women also tend to experience faster aneurysm growth, which can lead to earlier rupture.

Knowing the signs of an aortic aneurysm — and getting help quickly — are very important. Symptoms such as chest and jaw pain, feeling faint or having difficulty breathing, or experiencing weakness on one side of the body are all potential signs of an aneurysm.

Why Choose Stormont Vail Health

Located in Topeka, Kansas, Stormont Vail Health is a community-focused healthcare organization. It offers health care services close to home making it easier for you to get the care you need.

Stormont Vail Hospital has also received several accreditations from The Joint Commission, including Advanced Primary Stroke Center and Chest Pain.

Stormont Vail has the experienced and skilled medical team to help you get treatment for your aortic aneurysm in a safe, trusted environment.

Next Steps

Make an Appointment

To make an appointment at the Cotton O’Neil Heart Center, call (785) 270-4000.

See a Primary Care Provider

  • Call (785) 270-4440 to schedule an appointment with your Stormont Vail primary care provider.
  • Not a Stormont Vail patient? Call (785) 270-4440 to set up your first appointment with one of our primary care providers.