Endovascular surgery i.e. surgery from within the blood vessels, is being increasingly utilized for various disorders of aorta and other large arteries. This technique was first used to treat the ballooning dilatation (aneurysm) of the abdominal aorta starting from 10 years ago. The applications have now extended to include the thoracic aortic pathology (the large artery in the chest) as well as arteries in the pelvis (iliac arteries) and in the groin (femoral arteries).
The classic treatment for problems involving the aorta and other large arteries was open surgery and replacement of the abnormal part of the artery with an artificial tube. Although this procedure has proven efficacy and long term results, it was not tolerated well by many patients due to the extent of surgical procedure and coexisting problems in other organ systems commonly found in these patients.
Endovascular surgery techniques entail placement of artificial tubes into the large arteries through small incisions and exclusion of the diseased part of the vessels. This procedure circumvents the large incisions and lengthy operations and has been the preferred form of treatment in higher risk patients in recent years.
How is it done?
Most of these procedures are performed under general anesthesia. Limited incisions are placed in the groin and diseased segment of the aorta is identified with angiography (injection of dye into the blood vessel lumen). The diameter and length of the diseased segment is accurately determined. A synthetic tube graft attached on a metal cage (stent) is then introduced through the artery and placed into the diseased aortic segment.
A major difference between the open procedures and endovascular repair is that diseased part of the artery is not removed surgically however it is ‘excluded’ from the circulation. This procedure prevents blood entering into the abnormal part of the vessel and reroutes the circulation through the new synthetic tube. Exclusion of the abnormal aortic segment prevents rupture or tear of the weakened part of the artery and results in shrinkage and eventual scarring of the diseased segment.
Risks of the procedure:
- Injury to the blood vessels in the groin while inserting the artificial graft
- Displacement/migration of the synthetic tube graft early or late after the operation
- Yapay damarın ameliyat sırasında veya geç dönemde yerinden oynaması
Postopertaive recovery after this procedure is relatively short compared to the open counterparts due to absence of large incisions and short duration of the procedure. Patients would stay in the intensive acre unit 1 night and total hospital syat is usually 2-3 days.
You surgeon would like to see you in the office regularly after discharge for a few years. A computerized tomography scan is also done routinely several months after the procedure to evaluate the new graft.
Notify your doctor immediately if you have one of the complaints below:
- Redness and swelling or drainage from the wounds
- Extreme weakness
- Fever over 101.4 F
- Increasing abdominal or back pain