What are the treatment options available for Abdominal Aortic Aneurysm in India?
Abdominal aortic aneurysm can be repaired in one of the following ways:
Open Repair Surgery
Open repair surgical procedure is the traditional method used to repair the abdominal aortic aneurysm if it is large in size or progressing at a continuous rate. During the procedure, a catheter is placed into the bladder to drain urine. The surgeon makes an incision from the sternum to the area below the navel to access the abdomen. Otherwise, the incision may also be made across the abdomen from underneath the left arm across to the abdominal center reaching towards the area below the navel. A clamp is placed on the aorta above and below the aneurysm site. This helps stop the blood flow temporarily. The aneurysm sac is removed and replaced by a graft made up of a durable polymer. The chest is closed with the help of stitches. A hospital stay of 4 to 7 days is required after the open repair surgery. This surgical procedure has a long-term success rate of more than 90 percent.
Endovascular aneurysm repair (EVAR) – Endovascular Stent Grafting
Endovascular aneurysm repair is a minimally invasive technique as it involves small incisions in the groin region to access the lumen of the abdominal aorta. During this procedure, an incision is made in the groin area to expose the femoral arteries. A needle is then inserted into the femoral artery with the help of fluoroscopy. A thread wire is guided to the site of the aneurysm. The needle is then removed and a sheath is slid over the guided wire. A contrast dye is injected to see the position of the aneurysm. Specially designed instruments are used to guide the endovascular stent graft up into the aorta to reach the site of the aneurysm. The stent is now opened and grafted to the walls of the aorta. The aneurysm will eventually shrink around this stent.
A contrast dye is inserted again to check the position of the stent and any leakage around the aneurysm area. Once the surgeon gets convinced that the aneurysm is not leaking, all the instruments are removed and the incisions are sutured back together. A patient after endovascular aneurysm repair must stay in the hospital for two to three days. Frequent monitoring is required after the surgery to ensure the proper functioning of the stent. The success rate of this procedure depends upon the size, shape, and location of the aneurysm.