What is endovascular aortic aneurysm repair?

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Endovascular repair for an aortic aneurysm: Overview

Endovascular aortic aneurysm repair fixes an aneurysm in your aorta. An aneurysm is a weak or bulging part of a vein or artery. Your aorta is a large artery. It carries blood from your heart through your belly to the rest of your body.

If you don't fix this problem, your aorta could burst. This can cause death.

The procedure is called endovascular because a doctor repairs the aneurysm from the inside of the damaged blood vessel (the aorta). It's not a surgery. Local or general anesthesia might be used.

Your doctor may make small cuts in the groin area. Thin tubes, called catheters, are inserted through the cuts and into blood vessels. The doctor guides the catheters into the aorta. A man-made tube is placed in the aneurysm. This tube is called a stent graft.

After the procedure, your blood will flow through the stent graft. It will not push on the aneurysm.

You may spend 1 to 3 days in the hospital. You may be able to return to work and many of your daily activities 1 to 2 weeks after the procedure.

How can you care for yourself after endovascular repair of an aortic aneurysm?

Activity

  • Rest when you feel tired. Getting enough sleep will help you recover.
  • Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
  • Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or aerobic exercise. Your doctor will tell you when it's okay to do strenuous activity.
  • Ask your doctor when you can drive again.
  • You will probably need to take at least 1 to 2 weeks off from work. It depends on the type of work you do and how you feel.

Diet

  • You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
  • Drink plenty of fluids (unless your doctor tells you not to).
  • You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fiber supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

  • Your doctor will tell you if and when you can restart your medicines. You will also get instructions about taking any new medicines.
  • If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
  • Be safe with medicines. Take pain medicines exactly as directed.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
    • Do not take two or more pain medicines at the same time unless the doctor told you to. Many pain medicines have acetaminophen, which is Tylenol. Too much acetaminophen (Tylenol) can be harmful.
  • If you think your pain medicine is making you sick to your stomach:
    • Take your medicine after meals (unless your doctor has told you not to).
    • Ask your doctor for a different pain medicine.
  • If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

  • If you have strips of tape on the incisions, leave the tape on for a week or until it falls off.
  • Wash the area daily with water and pat it dry. Other cleaning products, such as hydrogen peroxide, can make the wounds heal more slowly. You may cover the area with a gauze bandage if it weeps or rubs against clothing. Change the bandage every day.
  • Keep the area clean and dry.
  • You may shower 24 to 48 hours after the procedure, if your doctor okays it. Pat the incision dry.
  • Do not soak the catheter sites until they are healed. Don't take a bath for 1 week, or until your doctor tells you it is okay.
  • Watch for bleeding from the sites. A small amount of blood (up to the size of a quarter) on the bandage can be normal.
  • If you are bleeding, lie down and press on the area for 15 minutes to try to make it stop. If the bleeding does not stop, call your doctor or seek immediate medical care.

How do you prepare for endovascular repair for an aortic aneurysm?

Procedures can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for your procedure.

Preparing for the procedure

  • Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
  • Understand exactly what procedure is planned, along with the risks, benefits, and other options.
  • Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your procedure. Your doctor will tell you if you should stop taking any of them before the procedure and how soon to do it.
  • If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your procedure. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
  • Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

What can you expect as you recover from endovascular repair for an aortic aneurysm?

You may spend 1 to 3 days in the hospital. You can expect the cuts (incisions) in your groin to be sore for 1 to 2 weeks.

You may feel more tired than usual for 1 to 2 weeks after the procedure. You may be able to do many of your usual activities after 1 to 2 weeks. But you will probably need up to 4 weeks to fully recover. You may need to take at least 1 to 2 weeks off from work. It depends on the type of work you do and how you feel.

You will need regular tests, such as a CT scan or an ultrasound, to check for problems with the graft. You might have the test one or more times in the first year after this procedure. Then you will have at least one test each year for the rest of your life.

Be sure to tell your dentist and doctors that you have the graft in your aorta. This is important because you may need to take antibiotics before certain procedures to prevent an infection.

After endovascular repair of an aortic aneurysm: Overview

Endovascular aortic aneurysm repair is a procedure to fix a weak and bulging section of the aorta. The aorta is the large blood vessel (artery) that carries blood from the heart through the belly to the rest of the body. The doctor used thin tubes, called catheters, to put a man-made tube called a graft inside the aneurysm. Blood will pass through the graft in the aorta without pushing on the aneurysm.

You can expect the areas where the catheters were inserted to be sore for 1 to 2 weeks. If you have stitches or staples, the doctor may need to take them out.

You may feel more tired than usual for 1 to 2 weeks after surgery. You may be able to do many of your usual activities after 1 to 2 weeks. But you will probably need up to 4 weeks to fully recover.

Be sure to tell your dentist and doctors that you have the graft. This is important because you may need to take antibiotics before certain procedures to prevent an infection.

You will have regular tests, such as a CT scan or an ultrasound, to check for problems with the graft. You may have at least one test each year.

How is endovascular repair for an aortic aneurysm done?

During this procedure, a doctor repairs an aneurysm from the inside of the damaged blood vessel (the aorta). Local or general anesthesia might be used.

To do the procedure, the doctor may make one or two cuts (incisions) in your groin area. Then the doctor puts small tubes (catheters) through the cuts and into blood vessels. The doctor may use the catheters to put dye in your arteries. The dye makes your aorta show up on X-rays.

The doctor uses the catheters to move a man-made tube, called a stent graft, through the blood vessels until it reaches the aorta. The doctor expands the graft inside of the aneurysm. When the graft is in place, the doctor takes out the catheters. The doctor may use stitches to close the cuts in the groin area. Blood passes through the graft in the aorta without pushing on the aneurysm.

What happens on the day of your endovascular repair for an aortic aneurysm?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your procedure may be canceled. If your doctor told you to take your medicines on the day of the procedure, take them with only a sip of water.
  • Take a bath or shower before you come in for your procedure. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

  • Bring a picture ID.
  • You will be kept comfortable and safe by your anesthesia provider. You may be asleep during the procedure. Or you may get medicine that relaxes you or puts you in a light sleep. The area being worked on will be numb.
  • The procedure will take about 1 to 4 hours.

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