Aortic Aneurysm

An aneurysm is simply a weakening and bulging of the aortic wall. The aorta is the main blood vessel that runs from the heart down through the chest and tummy. An aortic aneurysm can be dangerous if not detected early. It can get bigger over time and can burst leading to catastrophic life-threatening bleeding. Most of the time there are no symptoms until it ruptures (bursts), but some people may experience abdominal or back pain. If you are diagnosed with an aneurysm, there are several options available. Most aneurysms are at low risk of rupturing, particularly if it is small to medium in size (between 3 – 5.4cm across). Yearly monitoring with ultrasound scan and lifestyle changes (such as stopping smoking, well controlled blood pressure , well controlled diabetes and eating healthily) is recommended. For aneurysms identified as at risk of bursting, the vessel may be strengthened via surgery to prevent this happening.

Treatment Options

Endovascular Aneurysm Repair (EVAR)

During this surgery, a small graft made of a fabric-covered tube is inserted via a small cut in the groin area, and fed up through the vessel to repair the aneurysm. This is performed under general anaesthetic, and most patients will spend just 1 overnight stay in hospital. Endovascular aneurysm repair is less invasive than open aneurysm repair, but the long-term outcome is usually the same. You will likely need regular check-up scans to make sure the graft remains in place and is still working properly.

Risks

As with any surgical procedure, there is a risk of bleeding and infection, and a risk of blood clots, further procedures, endoleak, stroke and heart attack. Other factors can increase your risk- such as the shape of the aneurysm, and whether you have any other conditions, like kidney or lung disease. During your consultation, Mr Oluwole may order tests that will help assess your risk and will discuss the best course of action with you, along with the risks of complications in more depth.

Open Aneurysm Repair

If endovascular aneurysm repair is not appropriate or suitable, then there is the option for an open aneurysm repair. The aneurysm is accessed through a cut in the abdomen, and the graft- a fabric covered tube- is sutured in place directly to replace the diseased section of artery. This is a much more invasive surgery and therefore takes longer to recover from, but usually continues to work for the rest of your life. Most patients will spend 7-10 days in hospital, and it may take about three months to return to normal levels of activity.

Risks

As with any surgical procedure, there is a risk of bleeding and infection, and a risk of blood clots, stroke, heart attack and death 1%. Other factors can increase your risk- such as the shape of the aneurysm, and whether you have any other conditions, like kidney, heart or lung disease. During your consultation, Mr Oluwole may order tests that will help assess your risk and will discuss the best course of action with you, along with the risks of complications in more depth.