Advanced Stent-Graft Procedures
Endovascular stent surgery is a minimally invasive surgical procedure performed to manage an aneurysm in the aorta, the main blood vessel that carries oxygen-rich blood away from the heart to the different parts of the body. Aortic aneurysm is a condition characterized by an abnormal ballooning or bulging of a section of the aorta due to weakness in the wall of the blood vessel.
An aneurysm can develop anywhere along the aorta:
- Aneurysms that occurs in the segment of the aorta that transcends down the chest are called thoracic aortic aneurysms
- Aneurysms that occur in the segment of the aorta that passes through the abdomen are called abdominal aneurysms
Endovascular stenting is usually recommended if conservative treatment measures have failed to relieve the symptoms of aortic aneurysm or there is a risk of rupture due to the large size of the aneurysm. The decision on endovascular stenting is based upon the aneurysm size and rate at which it is enlarging.
Before undergoing surgery, inform your doctor about any medications or supplements you are taking. You may need to discontinue certain medications. Also, inform your doctor about any existing medical conditions or illness. Avoid oral intake of any food or drink, including water, for about 9 to12 hours before your surgery. Your prescribed medications can be taken along with a small sip of water.
During the procedure, an endovascular stent is placed inside the aorta to protect the aneurysm from rupturing. The procedure is performed in the operating room with the patient under general or spinal anaesthesia. Your doctor will make a tiny incision over the groin and insert a small tube called a catheter into the femoral artery. With the help of X-ray imaging, the catheter is guided to the site of the aneurysm for the placement of the stent graft. The stent is then connected to the walls of the aorta. The aneurysm will contract around the stent. After the procedure X-rays are taken to ensure the right placement of the stent and to check for leakage of blood. The catheter is then removed and the incision, in your groin, is closed.
After the surgery, you may be taken to an intensive care unit (ICU) where you will be closely monitored. You may require staying at the hospital for about three days. You will be given blood thinning medications to prevent blood clot formation. Pain medications are also given to ease any discomfort. Your doctor may recommend special stockings for your legs to help prevent blood clot formation in your legs.
The possible complications of endovascular repair include:
- Bleeding around the graft that requires surgery
- Stent blockage
- Migration of the stent
- Blood vessel damage
- Kidney damage