All about Aneurysm repair
An aneurysm is a blood-filled bulge in the walls of an artery. Arteries supply blood from the heart to other parts of your body. When the blood flows through the arteries, it exerts pressure on its walls. The walls of your arteries are elastic, which helps it to absorb this pressure.
Due to various reasons, your artery walls can become weak in certain areas. When the blood flows, the pressure is more on these weak areas. These areas balloon out slowly to form an aneurysm. In some, the aneurysm may burst to cause various complications. An aneurysm repair surgery helps to strengthen the walls of an artery to prevent it from rupturing.
Symptoms of aneurysm
Aneurysms are more common in the aorta and cerebral arteries of the brain. But it can occur in any of the arteries in your body. Family history, collagen vascular disease, etc. are the most common causes.
You may have an aneurysm, without you knowing it. It is because you will not have any symptoms due to it. Symptoms will occur only when the aneurysm bursts or becomes very big. The rupture of an aneurysm can lead to severe internal bleeding. Prompt treatment can prevent complications. More often, you will know about the presence of an aneurysm during routine medical tests.
Types of aneurysms
Aneurysms mainly occur in the aorta and cerebral arteries. Peripheral artery aneurysms can occur but are rare.
Aorta is the largest artery in your body. It originates from the heart and runs down the chest or thorax to your abdomen. All through its course, it branches off to smaller arteries that supply blood to the body.
The normal width of the aorta is 2 to 3 cm. But, in areas of an aneurysm, the width will be around 5 to 6 cm.
The aneurysms in the upper part of the aorta that passes through the chest are called thoracic aortic aneurysms. Those occurring in the abdominal region are called abdominal aortic aneurysms.
Thoracic aortic aneurysm
This type of aneurysm occurs in the thoracic part of the aorta. Smoking and high BP increases your risk.
The symptoms you will have with a TAA are
- Pain in the chest
- Hoarseness of your voice
- Difficulty in breathing
Usually if the aneurysm is wider than 6cm, you will need an aneurysm repair surgery. For smaller ones, you will need regular check-ups to watch whether the size is increasing.
Abdominal aortic aneurysm(AAA)
An AAA occurs in the abdominal part of your aorta. Smokers and those over the age of 65 are more at risk.
The symptoms of AAA are
- Pain in the abdomen
- A pulsating sensation in the abdomen
- Pain in the lower back
If the width is more than 6cm, you will need immediate surgery. The rupture of the aneurysm can cause various complications.
Aneurysms can also occur in other arteries of your body.
Treatment for aortic aneurysms
If you have an aortic aneurysm, the doctor will look into its size before deciding on the type of treatment.
If the aneurysm is less than 5cm, you will not have an aneurysm repair surgery. That is because the chances of it rupturing are small. You will have periodic ultrasound scans to assess the size.
If by any chance, the size is increasing rapidly, surgery will become necessary.
Aortic Aneurysm repair surgery
The surgeon will repair your aneurysm by open surgery or minimally invasive surgery.
Open aneurysm repair surgery
In open surgery, your surgeon will expose the aneurysm by making a large incision. In TAA, the incision will be on the chest while in an AAA, it will be in the abdomen.
You will have general anesthesia during the surgery to put you to sleep. The surgeon will then make the incision to expose the aneurysm. The next step is to clip the aorta at both ends of the aneurysm. It will prevent blood from flowing into it.
Your surgeon will then remove the aneurysm entirely from both sides. They will then attach an artificial graft to replace the missing part using a material called Dacron. Then the surgeon secures the graft with sutures.
Once this is complete, the surgeon will remove the clips at both ends. The blood will start flowing through the graft. The surgeon will look for any leakages. Once everything is alright, the surgeon will close the incision with sutures or staples. Before closing, the surgeon will leave a drain in the site of surgery. It helps to remove any fluids that accumulate in the area.
The operation room staff will then move you to the observation room. After an hour or so, you will wake from your sleep.
Endovascular aneurysm repair surgery (EVAR)
In this surgery, there will be one or two small incisions instead of one large incision. It helps you to recover faster as the wounds are minor in size.
For an endovascular repair, you will have general anesthesia. The surgeon will then make a small incision in your groin to expose the femoral artery. He or she will then introduce a thin wire to the artery. The tip of the wire will have an expandable stent.
The surgeon will screw the wire up to the aneurysm. He or she will then place the stent inside the walls of the aneurysm. The stent will be long and will rest on the normal artery walls outside the area of the aneurysm.
The surgeon will then slowly expand the stent to the normal width of the aorta. The blood will then flow only through the stent and will exclude the walls of the aneurysm. In effect, the stent walls will act as the walls of the aorta in that area.
The stents will have small barbs that help it to anchor close to the artery walls.
You will recover faster from an EVAR than from open surgery. The complications are also less since the wound is only a minor one.
Aneurysm repair surgery benefits
The rupture of an aneurysm can cause various complications ranging from minor to very severe. The rupture of an aortic aneurysm can cause severe internal blood loss.
An aneurysm repair surgery will help to prevent the complications associated with the rupture of an aneurysm
Frequently asked questions
If the aneurysm is large, you will need an open aneurysm repair surgery where the surgeon will open the chest cavity to reach the aorta. During it, the surgeon will cut and remove the aneurysm its ends and place a blood vessel graft in its place. It will take anywhere between two to five hours to complete it. Complete recovery will take two to three weeks
Aneurysms are blood-filled bulges in the walls of the blood vessels. The causes are the weakness and loss of elasticity of the walls of the blood vessels. During a repair surgery, the surgeon will remove the aneurysm at both ends and place a graft. So the chances of an aneurysm coming back on the same site are very less. Also, taking steps to reduce the risk of aneurysms can lessen the chances of it occurring elsewhere
Aneurysms that are more than 4- 5 cm in diameter will need surgery to prevent any complications like rupture. A ruptured aneurysm is a medical emergency and also tough to treat. Smaller aneurysms will benefit from a treatment called endovascular coiling, where the surgeon will put a stent with a blood vessel graft in the area. It helps to strengthen the walls and prevent a rupture
An aortic aneurysm that ruptures will cause severe internal bleeding that is difficult to control. Almost eighty percent of those who have a ruptured aneurysm will not make it to a hospital for treatment. Even with treatment, the chances of survival are slim. It is always better to do surgery early to prevent any complications
Aneurysm treatment in India includes open aneurysm repair surgery and endovascular coiling.The cost of aneurysm repair surgery in India will be around 12000 to 18000 USD