An aneurysm is a balloon-like expansion of the aorta caused by the pressure of blood flowing through the weakened section of the artery

How do they form?

When the wall of an artery becomes weakened, the pressure within the vessel can cause the wall to bulge out forming a localized dilation, or aneurysm. Although a small percentage of such cases are due to inherited factors, the vast majority appear to represent a variant of atherosclerosis and tend to occur in a limited number of locations. Most aneurysm seem to occur in the abdominal aorta, the main artery lying in the center of the abdomen. Other common sites include the groin and the vessels behind the knee. Once an aneurysm forms, it tends to progressively enlarge until it ruptures or causes other symptoms, such as severe back pain, which precipitate the need for treatment. Because aneurysms tend to occur in older patients and don't ALWAYS enlarge, not all aneurysms require treatment. In the abdominal aorta, aneurysms are usually repaired when their width exceeds 5cm which is roughly equivalent to 2 1/2 in. If an aneurysm is smaller when it is first detected, it can be followed with ultrasound scans every 6-12 months. If sequential scans show rapid enlargement or the 5 cm threshold is exceeded, aneurysm repair can prevent rupture and prolong the patient's life.

Does aneurysm repair always require a major operation and prolonged hospital stay?

No. Although aneurysms cannot be treated medically, there is a new treatment, the endovascular graft, which allows a graft to be inserted WITHIN THE ARTERY using a specially designed catheter introduction system. This technique has recently been approved by the FDA for use (October 1999). We were one of the first vascular surgeons in the country to be trained in and certified to perform the procedure. Although not all aneurysms are suitable for endovascular grafting, it is important that you select a surgeon that is experienced with this technique.

 

What types of operations are available?

Once you have undergone the appropriate tests to evaluate your aneurysm, we will sit down and talk to you about the possible options for operation. The traditional ("open") repair may be recommended if the aneurysm morphology is deemed not suitable for safe endovascular repair. If your aneurysm has the suitable morphology for endovascular repair we will discuss the options with you and decide on the appropriate type of graft to use.