Endovascular Abdominal Aortic Aneurysm (AAA) Repair

Endovascular aortic repair is surgery to treat a weakened and enlarged area (aortic aneurysm) in the large blood vessel that carries blood from the heart to the vital organs (aorta). The endovascular approach is rapidly becoming the preferred treatment for abdominal aortic aneurysms and also is becoming more available for the treatment of thoracic aortic aneurysms. The Cooper Vascular and Endovascular Surgery Program has a renowned team of vascular and endovascular surgeons who offer world class care and have extensive experience performing endovascular abdominal aortic aneurysm repair. Cooper Vascular Surgeons helped pioneer these advanced aneurysm treatment techniques.

Indications for Endovascular Abdominal Aortic Aneurysm Repair

Endovascular aortic repair may be recommended to treat an abdominal aortic aneurysm.

Understanding Endovascular Abdominal Aortic Aneurysm Repair

The endovascular abdominal aortic aneurysm repair procedure is performed inside the aorta (endovascular) using thin, long tubes (catheters) and a tube composed of fabric supported by a metal mesh (stent graft), which is used to reinforce the weakened area and allow blood to pass through.

During the endovascular repair procedure, the surgeon makes small incisions in the groin area to access the arteries that connect to the aorta. A guide wire is inserted through the large artery that supplies blood to each leg (femoral artery) just beyond the affected area of the aorta where the aneurysm is. Using X-ray guidance, the surgeon inserts a catheter (a long, thin tube) containing an endovascula stent graft over the guide wire. The stent graft is a fabric tube supported by metal wire stents (also called a scaffold) that is used to reinforce the weakened area of the aorta. The surgeon then moves the stent-graft in the catheter along with the guide wire to the site of the aneurysm. There, the catheter is withdrawn and the stent graft expands like a spring to fit against the wall os the aorta on either side of the aneurysm. Once it is securely in place, the stent graft creates a new passageway for blood flow without pushing on aneurysm. Over time, the aneurysm will shrink because of the lack of pressure on it.

Advantage of Endovascular Abdominal Aortic Aneurysm Repair

Endovascular repair offers these advantages:

  • The procedure typically takes 1 to 3 hours.
  • Patients can go home in a few days after the procedure.
  • There are smaller scars and less trauma compared with open surgical techniques.
  • Most people return to their normal activities in 2 to 6 weeks after the procedure.

Follow-up for Endovascular Abdominal Aortic Aneurysm Repair

Patients who have an endovascular stent-graft must return to their doctor regularly to have the position of the stent-graft monitored by a CT scan.