Aortic Stent Graft Repair of Abdominal Aortic Aneurism

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Michael Cohn, M.D.

Introduction:
The Abdominal Aortic Aneurysm is a bubble like enlargement of the aorta which typically occurs at the distal aorta, just before the aorta divides into the two iliac arteries to each leg. This is caused by a combination of atherosclerotic disease (which weakens the wall of the aorta) and pounding pulsations of the blood flow in the aorta (which, of course, is caused by the pumping action of the heart).

Natural Course:
The abdominal aortic aneurysm, like all aneurysms, have a tendency to enlarge over time. As, they enlarge, there is increased risk of leakage and possible life-threatening rupture. The aneurysm can be watched with annual sonogram or cat scan. Treatment is indicated when the aneurysm reaches a large size, usually 5 centimeters or greater in diameter.

Old Treatment:
In the past, treatment has been surgical repair of the Abdominal Aortic Aneurysm with an open operation on the abdomen under general anesthesia done by a vascular surgeon. This is a quite lengthy operation which involves placement of a synthetic graft inside the aneurysm which serves as a new aorta.

New Treatment:
This new treatment is called: Stent Graft Repair of the Abdominal Aortic Aneurysm.

Watch the movie below to see how this is done.

Explanation:
The main advantage of the Stent Graft Technique, is that it avoids the lengthy open abdominal operation of the older surgical operation. The Stent Graft is a tube which is introduced in a collapsed form inside the aorta through a catheter placed into the aorta. The catheter enters the Femoral artery in the groin and is advanced up to the level of the aortic aneurysm. Both right and left femoral arteries are used since there is a right and left iliac limb of the graft.

The stent graft is deployed by expanding an angioplasty balloon inside the graft under flouroscopy. After final deployment, the catheters, balloons and wires are removed, leaving the stent graft in place.

Stent Graft Repair Movie
This movie demonstrates repair of Abdominal Aortic Aneurysm with the Stent Graft technique.

Red=aneurysm.
Green=balloon.
Black=stent graft

Aortic Aneurysm Treated with Stent Graft: Case Study

Abdominal Aortic Aneurysm

Initial Angiogram showing the aneurysm (red arrows)

Final Result after stent graft placement. Notice Aneurysm is now gone.