Treatment of abdominal aortic aneurysm
Your treatment for an AAA will depend on your symptoms and the size of your aneurysm.
If you have a small aneurysm, surgery isn't usually advised but you will need regular ultrasound checks to see if your aneurysm is expanding. It's also important to manage your condition by changing your lifestyle and treat any condition that may be causing the aneurysm (such as high blood pressure).
Elective or planned surgery is often advised if your aneurysm is:
- larger than 5.5cm
- expanding by more than 1cm per year
- causing you pain
Emergency (life-saving) surgery is needed if your aneurysm ruptures.
There are two main surgical options for AAA. Both are usually performed under a general anaesthetic. This means you will be asleep during the operation.
This is the traditional method of treating aneurysms. It's a major operation in which your surgeon opens your abdomen to access the aorta and inserts a graft into the weak area of the aorta. The graft can be either a piece of blood vessel taken from another place in your body or it can be synthetic. A synthetic graft is made out of an elastic material and is similar to your normal healthy aorta. The blood flows through the graft inside the aorta instead of going through the aneurysm and prevents the aneurysm getting bigger. For more information watch this video
The operation can be done using keyhole surgery. Keyhole surgery is less invasive and involves making two or three small cuts on your abdomen. Your surgeon will insert a tube-like telescopic camera, which will send pictures to a monitor so he or she can see the aneurysm. Your surgeon will put the graft into place using specially designed surgical instruments that will be passed through the other cuts. However, keyhole surgery isn't suitable for everybody.
Endovascular stent graft replacement
Sometimes aneurysms can be treated using a new procedure called endovascular stent graft replacement (or endovascular aneurysm repair, EVAR). A stent – a tube that is covered with synthetic graft material – is fed through the femoral arteries in your groin up though the aorta to the area of the aneurysm. Your surgeon uses X-ray images to guide the placement of the stent. The graft material bonds with the arterial wall and the blood flows through the stent instead of the weakened aneurysm. However, stents aren't suitable for everyone – it depends on the location of the aneurysm and other factors. For more information see the health factsheet on endovascular aneurysm repair.
Availability and use of different treatments may vary from country to country. Ask your doctor for advice on your treatment options.