Endovascular Aneurysm Repair

Endovascular Aneurysm Repair

During the Procedure

  • You will be required to take off any jewelry or other objects that may interfere with the procedure.
  • You will be requested to take off your clothing. You will be provided a gown to wear instead.
  • You will be requested to empty your bladder before the procedure.
  • Your nurse will shave the surgical site should there be too much hair.
  • An IV line will be inserted in your arm or hand.

The Procedure

  • You will be positioned in your back on the operating table.
  • Your anesthesiologist will constantly observe your heart rate, blood pressure, breathing and blood oxygen level during the surgery. By the time you are sedated, a breathing tube is usually inserted by way of your throat into your lungs and you will be plugged into a ventilator, which will breathe for you during the procedure.
  • Your surgeon may opt for a regional anesthesia as an alternative for general anesthesia. Regional anesthesia is anesthetic introduced in the body through an epidural (in the back) to numb the surgical site. Your surgeon can talk to you during the procedure. Your doctor will decide which type of anesthesia is best for you.
  • Your surgeon will create an incision in the skin in each groin and then locate the femoral arteries. By means of fluoroscopy (a kind of X-ray that broadcasts images to a RV-like monitor), your surgeon will insert a guide wire (catheter) through the femoral artery. See figure below.
    Abdominal Aneurysm Stent
  • The catheters are used to guide and deliver a stent-graft (a tube composed of fabric supported by a metal mesh called a stent) through the blood vessels to the site of the aneurysm.
  • The stent-graft is in a collapsed form while being inserted and when it gets to the aneurysm, it will be expanded and attached to the wall of the aorta. As soon as the stent-graft is in place, the blood flows through the graft, avoiding the aneurysm. With time, the aneurysm generally shrinks because the blood pressure is now exerted on the wall of the graft. See Letter B, figure above.
  • Your surgeon will check for leaks using an aortogram and if no leak is confirmed, the instruments are removed.
  • Your surgeon will suture the incisions and a sterile dressing will be applied.