One of the expressions of atherosclerosis is expansion of the arteries due to a genetic disorder evidenced by the weakening of the arterial wall. Along with other risk factors, such as smoking and high blood pressure, this could lead to expansion of the aorta. Common sites for such expansion appear in the thoracic aorta and the abdominal aorta, demonstrated by aortic aneurysms in the abdomen and chest. Expansion of the artery can lead to a life-threatening rupture. Early detection and preliminary treatment are lifesaving.
Once the aneurysm has been detected, it is recommended to undergo a computed tomography angiography (CTA) imaging scan (a scan with injected contrast material) to determine and plan for continued treatment. Should the case require endovascular treatment then a stent graft will be ordered in the appropriate dimensions according to the findings of the CTA. Based on the patient’s cardiac evaluation together with information regarding any other related diseases, the patient will be prepared for the procedure.
Aortic expansion over a diameter of 6 cm in the chest and 5 cm in the abdomen significantly increases the likelihood of rupture, and therefore requires immediate treatment. Today, 70-80% of cases are treated using the endovascular approach via stent grafting. In some cases, this procedure can eliminate the need for more extensive and complicated open abdominal aortic surgery.
Course of treatment
The procedure is performed in the operating room by opening the groin to gain direct access to the artery in the groin. This procedure can be performed under local or general anesthesia, and its duration is between 3-4 hours on average, after which the patient is transferred to the intensive care unit for further observation.
In most cases the patient will be transferred to a ward on the day after the surgery, when he/she will be capable of getting out of bed and functioning independently. Length of hospitalization is 4-3 days on average, after which there is a gradual return to normal activity.
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