When do you operate on aaa

The risk of graft problems is lower than with endovascular surgery. The graft will usually work well for the rest of your life and you will not usually need regular scans to check it. This animation explains what happens when you have open surgery for an abdominal aortic aneurysm. A burst aneurysm is treated with emergency surgery using the same techniques used for a large aneurysm.

The decision about whether to perform open or endovascular surgery is made by the surgeon carrying out the operation. Page last reviewed: 21 May Next review due: 21 May Treatment - Abdominal aortic aneurysm Contents Overview Treatment. The treatment for an abdominal aortic aneurysm AAA mostly depends on how big it is.

Ask your doctor if you're not sure what size your aneurysm is. Scans are done: every year if you have a small AAA every 3 months if you have a medium AAA Surgery may be offered if the scans show that a AAA larger than 4cms has grown by more than 1cm over 12 months. Then the doctor uses stitches or staples to close the incision in the belly. You can expect the cut incision in your belly to be sore for a few weeks. You will feel more tired than usual for several weeks after surgery.

You may be able to do many of your usual activities after 4 to 6 weeks. But you will probably need 2 to 3 months to fully recover. You will have follow-up visits with your doctor to check on your recovery. Then, you will likely have annual checkups. You might have a test, such as a CT scan or ultrasound , every few years to check your repaired aorta. Be sure to tell your dentist and doctors that you have the graft in your aorta. This is important because you may need to take antibiotics before certain procedures to prevent an infection.

Repairing an aortic aneurysm is typically recommended if the aneurysm is at risk of bursting open rupturing. Aortic aneurysms that are large, are causing symptoms, or are rapidly getting bigger are considered at risk of rupturing. Your doctor will work with you to decide which type of repair surgery, open or endovascular, is right for you. Your doctor will check:. When an aortic aneurysm is at risk of rupturing, or bursting open, the benefits of repairing the aneurysm can outweigh the risks.

Repairing the aneurysm lowers the risk of rupture. And the repair can help a person live longer. Repairing a smaller aneurysm, which doesn't have as high a risk of rupture, does not help a person live longer.

Most people who have open repair surgery recover well. It causes numbness in the lower body, abdomen, and chest. You will start solid foods as you can handle them. Arrangements will be made discharge from the hospital. This may include prescriptions for new medicines and directions for a follow-up visit with your doctor.

Once you are home, it will be important to keep the surgical area clean and dry. Your doctor will give you specific bathing instructions. Your doctor will remove the sutures or surgical staples during a follow-up office visit, if they were not before leaving the hospital. The surgical incision may be tender or sore for several days after an aneurysm repair procedure. Take a pain reliever for soreness as advised by your doctor. You should not drive until your doctor tells you it's OK.

Other activity restrictions may apply. Your doctor may give you other instructions after the procedure, depending on your particular situation. Repair of an AAA may be done in one of two ways: Open repair. The doctor will determine which procedure is right for y. Why might I need AAA repair done? An AAA may need repair for the following reasons: To prevent the risk of rupture To relieve symptoms To restore a good blood flow Size of aneurysm greater than 5 centimeters in diameter about 2 inches Growth rate of aneurysm of more than 0.

What are the risks of AAA repair? Some possible complications may include: Open repair Heart attack Irregular heart rhythms Bleeding during or after surgery Injury to the bowel Loss of blood flow to legs or feet from a blood clot Blood clot Infection of the graft Lung problems Kidney damage Spinal cord injury EVAR Damage to surrounding blood vessels, organs, or other structures Kidney damage Loss of blood flow to leg or feet from a blood clot Groin wound infection Groin hematoma large blood-filled bruise Bleeding Endoleak continual leaking of blood out of the graft and into the aneurysm sac with potential rupture Spinal cord injury Tell your doctor if you are allergic to or sensitive to any medicines, contrast dyes, iodine, or latex.

How do I get ready for AAA repair? Your doctor will explain the procedure to you and let you ask questions. Tell your doctor if you are pregnant or think you might be. You will be asked to fast for 8 hours before the procedure, generally after midnight.

You may receive a sedative before the procedure to help you relax. How is the AAA done? How is AAA open repair done? You will lie on your back on the operating table. A healthcare provider will insert a catheter into your bladder to drain urine. Your provider will apply a sterile bandage.

How is EVAR done? You will be placed on your back on the operating table. If the aneurysm extends above the renal arteries, the renal arteries must be reimplanted into the graft, or bypass grafts must be created.

Placement of an endovascular stent graft within the aneurysmal lumen via the femoral artery is a less invasive alternative that has been shown to have lower acute morbidity and mortality than open repair. This procedure excludes the aneurysm from systemic blood flow and reduces risk of rupture. Short-term results are good, and long-term results are favorable.

Complications include angulation, kinking, thrombosis, migration of the stent graft, and endoleak persistent flow of blood into the aneurysm sac after endovascular stent graft placement.

Thus, follow-up visits must be more frequent after endovascular stent graft placement than after a traditional repair. If no complications occur, imaging tests are recommended at 1 month, 6 months, 12 months, and every year thereafter. In general, for a successful endovascular repair, surgeons should choose a specific device that is appropriate for the patient's anatomic characteristics. In most cases, repair of aneurysms 5 cm does not appear to increase survival. Because patients vary in size, it is more precise to offer repair when the aneurysm is larger than twice the diameter of an area of normal aorta in that patient.

These aneurysms should be monitored with ultrasonography or abdominal CT every 6 to 12 months for expansion that warrants treatment. Treatment of a mycotic aneurysm consists of vigorous antimicrobial therapy directed at the pathogen, followed by excision of the aneurysm. Early diagnosis and treatment improve outcome. Myocardial infarction Acute Myocardial Infarction MI Acute myocardial infarction is myocardial necrosis resulting from acute obstruction of a coronary artery.

Symptoms include chest discomfort with or without dyspnea, nausea, and diaphoresis Diagnose using ultrasonography or abdominal CT; for unruptured aneurysms, CT angiography or magnetic resonance angiography can more precisely characterize aneurysm size and anatomy. Ruptured AAAs require immediate open surgery or endovascular stent grafting; even then, mortality is high. From developing new therapies that treat and prevent disease to helping people in need, we are committed to improving health and well-being around the world.

The Manual was first published in as a service to the community. Learn more about our commitment to Global Medical Knowledge. This site complies with the HONcode standard for trustworthy health information: verify here. Common Health Topics. Videos Figures Images Quizzes Symptoms. Risk factors.

Symptoms and Signs. Surgical complications. Key Points. Diseases of the Aorta and Its Branches.