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It’s Medical Monday!



Welcome to another Medical Monday! Today, we are going to be discussing the difference between open versus endovascular treatment options for AAA. 


As we reviewed in prior weeks, an abdominal aortic aneurysm (AAA) is a bulging or weakening in the wall of the aorta along the abdominal region. This can become very life threatening very fast as stretching of the aorta puts it at an increased risk for sudden rupture or aortic dissection. 


As a brief review - major risk factors for AAA include but are not limited to smoking, high blood pressure, family history of AAA, and connective tissue disorders such as Marfan’s disease: 


If you or a loved one has been diagnosed with AAA, you will meet with a surgeon who may offer different ways of repairing it with the two most common approaches being: open surgery and endovascular aneurysm repair (EVAR). Understanding the key differences between these two approaches will help you more confidently approach your doctor visits and ask questions!


Open Surgical Repair

Open repair was the traditional, treatment approach for years. After being put to sleep by anesthesia, a cardiac or vascular surgeon would make a controlled cut in your abdomen and remove the bulging aorta. After that they would sew in a synthetic graft to replace the old disease aortic tissue. This draft is very durable and should last a lifetime barring any infection. It is not biological tissue and therefore does not get “rejected” the way a heart transplant might. 


Endovascular Repair (EVAR)

EVAR is a minimally invasive alternative that has become increasingly common for managing AAA. Unlike open approaches, EVAR involves making small incisions in the groin and tunneling a stent graft up the groin into the inside of the aneurysm walls to re-inforce the weak tissue. During the operation, your surgeon will use X-ray imaging called fluoro to confirm they are in the right position:


While, EVAR offers several advantages including on average a shorter hospital stay and post-operative recovery, it is not suitable for al patients. Depending on aneurysm size, size of the arteries of your legs, and underlying diseases process, open repair may be preferred to endovascular. In some cases, only one option may be technically possible but it is important to discuss with your surgeon and inquire about their experience and outcomes with both approaches! 


And that’s it for this week! Be sure to continue to tune in to our weekly educational posts to learn more. Until next time - think aorta!

Adham 


 
 
 

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