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Endovascular abdominal aortic aneurysm repair is surgery to fix a widened part (or aneurysm) in your aorta, the large artery that carries blood to your belly, pelvis, and legs.
An aortic aneurysm is when a part of this artery becomes too large, or balloons outward, due to weakness in the wall of the artery.
Alternative NamesEVAR; Endovascular aneurysm repair - aorta; AAA repair - endovascular; Repair - aortic aneurysm - endovascular
DescriptionYou will lie down on a padded table in an operating room, in the radiology department of the hospital, or in a catheterization lab. You may receive general anesthesia (asleep and pain-free) or epidural or spinal anesthesia.
- Your doctor will make a small incision (cut) near the groin, to find the femoral artery. Then your doctor will insert a stent (a metal coil) and a manmade (synthetic) graft through the cut into the artery.
- The doctor uses x-rays to guide the stent graft up into your aorta, to where the aneurysm is located. The doctor will open the stent using a spring-like mechanism and attach it to the walls of the aorta. Your aneurysm will eventually shrink around it.
- The doctor will then use x-rays again to make sure the stent is in the right place and your aneurysm is not bleeding inside your body.
If you have bleeding inside your body from an aortic aneurysm, you will have open abdominal aortic aneurysm repair. Endovascular repair is rarely done for a leaking or bleeding aneurysm.
You may have an abdominal aortic aneurysm that is not causing any symptoms or problems. Your doctor may have found out about this problem from special tests called an ultrasound or CT scan. There is a risk that this aneurysm may open up (rupture) if you do not have surgery to repair it. However, surgery to repair the aneurysm may also be risky.
You and your doctor must decide whether the risk of having this surgery is smaller than the risk of bleeding if you do not have surgery to repair the problem. The doctor is more likely to recommend you have surgery if the aneurysm is:
- Larger (about 2 inches)
- Growing more quickly (a little less than 1/4 inch over the last 6 to 12 months)
Endovascular repair has a lower risk of complications around the time of the surgery. Your doctor is more likely to suggest this surgery if you have other more serious medical problems or if you are elderly.
RisksRisks for any surgery are:
- Reactions to medicines
- Breathing problems
- Blood clots in the legs that may travel to the lungs
- Heart attack or stroke
- Infection, including in the lungs, urinary tract, and belly
Risks for this surgery are:
- Bleeding before or after procedure
- Poor blood supply to your legs, your kidneys, or other organs
- Damage to a nerve, causing pain or numbness in the leg
- Bleeding around the graft requiring more surgery
Your doctor will do a thorough physical exam and tests before you have surgery.
Always tell your doctor or nurse what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription.
If you are a smoker, you should stop. Your doctor or nurse can help.
- During the 2 weeks before your surgery, you will visit your doctor to make sure medical problems, such as diabetes, high blood pressure, and heart or lung problems, are being treated well.
- You also may be asked to stop taking drugs that make it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), clopidogrel (Plavix), warfarin (Coumadin), naprosyn (Aleve, Naproxen), and other drugs like these.
- Ask your doctor which drugs you should still take on the day of your surgery.
- Always let your doctor know about any cold, flu, fever, herpes breakout, or other illness you may have before your surgery.
Do NOT drink anything after midnight, the day before your surgery, including water.
On the day of your surgery:
- Take the drugs your doctor told you to take with a small sip of water.
- Your doctor or nurse will tell you when to arrive at the hospital.
Most people stay in the hospital for 3 to 5 days after this surgery, depending on the type of procedure you had. During a hospital stay, you may:
- Be in the intensive care unit (ICU), where you will be watched very closely at first
- Have a urinary catheter
- Be given medicines to keep your blood thin
- Be encouraged to sit on the side of your bed and then walk
- Wear special stockings to prevent blood clots in your legs
- Receive pain medicine into your veins or into the space that surrounds your spinal cord (epidural)
Recovery after endovascular repair is usually fairly quick. You will need to be watched carefully over time for signs or symptoms that your repaired aortic aneurysm is leaking blood.
ReferencesGloviczki P, Ricotta JJ II. Aneurysmal vascular disease. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 65.
Greenhalgh RM, Powell JT. Endovascular repair of abdominal aortic aneurysm. N Engl J Med. 2008 Jan 31;358(5):494-501.
Lederle FA, Kane RL, MacDonald R, Wilt TJ. Systematic review: repair of unruptured abdominal aortic aneurysm. Ann Intern Med. 2007 May 15;146(10):735-41.
What else can I help you with?
How does an infrarenal abdominal aortic aneurysm get repaired?
The infrarenal abdominal aortic aneurysm can be repaired through different types of surgery. The two main types of surgical repair include open repair and endovascular repair.
What medicine should you take for an aneurysm?
Open surgical repair or endovascular repair.
What is the cpt code for aortic aneurysm repair and aortic valve and root replacement?
The CPT code for aortic aneurysm repair is typically 33860 for open repair or 33861 for endovascular repair, depending on the specific procedure. For aortic valve replacement, the code is 33405 for aortic valve replacement with a prosthetic valve. If the procedure also involves replacement of the aortic root, additional codes may apply based on the complexity and specific surgical approach. Always refer to the latest CPT guidelines for the most accurate coding.
What are normal results aortic aneurysm repair?
Repair of the aneurysm will provide normal blood flow to the systemic circulation. Pain associated with the aneurysm will be relieved by the repair. The risk of aneurysm rupture will be eliminated.
What is the purpose of aneurymectomy?
The purpose of aneurysmectomy is to repair an aortic aneurysm that is likely to rupture if left in place. Aneurysmectomy is indicated for an aortic aneurysm that grows to at least 2 in(5 cm) or for an aortic aneurysm of any size that is symptomatic.
What is the CPT codes for an endovascular repair using modular prosthesis with two docking limbs?
The CPT codes for an endovascular repair using a modular prosthesis with two docking limbs typically include 34701 for the endovascular repair of a thoracic aortic aneurysm and 34702 for the addition of the docking limb. Depending on the specifics of the procedure, additional codes may apply, such as those for imaging guidance or other associated services. Always refer to the latest CPT codebook or consult a coding specialist for the most accurate coding.
What conditions are most often treated by endovascular stent surgery?
coronary artery disease; narrowing (stenosis) of the carotid artery in the neck, a risk factor for stroke; and aortic aneurysm
How is a aortic buri treated?
An aortic burin, commonly referred to as an aortic aneurysm, is treated based on its size and symptoms. Small, asymptomatic aneurysms are often monitored with regular imaging, while larger or symptomatic aneurysms may require surgical intervention. Treatment options include open surgical repair, where the affected section is replaced with a graft, or endovascular aneurysm repair (EVAR), a less invasive procedure that involves placing a stent graft through the blood vessels. Managing risk factors, such as hypertension and cholesterol, is also crucial in treatment and prevention.
When is surgery done to repair an aortic aneurysm?
According to the Mayo Clinic, surgery for an aortic aneurysm depends on where the aneurysm is and how fast it is growing. If it's a slow growing aneurysm, the doctor might choose to simply wait and see how the aneurysm is progressing as it might not require surgery at all. If it is a fast growing aneurysm, the doctor would prefer to plan a surgery in advance but will perform an emergency surgery if the aneurysm is in danger of bursting.
What is endovascular thoracic stent-grafting surgery?
This is a minimally invasive procedure performed often by a vascular surgeon to repair an aneurysm in the thoracic (chest) area.
What is tortuous aortic arch?
It is an aortic arch with an aneurysm.
Is an ascending aortic aneurysm more dangerous than a descending aortic aneurysm?
No. Both are equally dangerous.
