Abdominal Aortic Aneurysm (AAA) Stent Graft

General Information | Scheduling, Insurance and Preparation | What to Expect


General information General Information

About Abdominal Aortic Aneurysms (AAA)

A small catheter is threat through the abdominal aortic artery to deploy a stent at the site of the aneurysm.

The aorta is the main blood vessel leading from the heart through the body. Abdominal aortic aneurysms (AAAs) occur when part of the aorta expands, most often because of atherosclerotic disease. The expanded area is called an aneurysm. In the aneurysm, the blood vessel wall may weaken and rupture. An AAA that has expanded to 5 centimeters or more has a 20% annual risk of rupture.

An abdominal aortic aneurysm is a life-threatening vascular disease. AAA rupture is often fatal. Only 10-20% of patients survive. When an AAA becomes 5 centimeters or larger, it is crucial to repair it.

About Abdominal Aortic Aneurysm Stent Grafts

With an abdominal aortic aneurysm stent graft, an interventional radiologist guides a long tube called a catheter through a small incision in the groin up to the location of the aneurysm. Through the catheter, the radiologist places a fabric tube (graft) that is long enough to span the bulging area of the AAA. The tube is held in place by a stent, which is a metal mesh tube. The stent exerts outward pressure against the graft and artery to keep the graft snugly in position. The blood then flows through the graft and bypasses the aneurysm. Without the pressure of flowing blood, the aneurysm will eventually shrink and the risk of rupture is greatly reduced.

AAA Stent Graft versus Surgery

Surgery has traditionally been the method for repairing an AAA. However, in 1999 the FDA approved the use of covered stent grafts for AAA. This provides a minimally-invasive alternative with a much shorter recovery period and decreased procedural risk. The long term results are comparable to surgery.

Not everyone is a candidate for an abdominal aortic aneurysm stent graft. People who are candidates may choose it over surgery for the following reasons:

  • Significantly shorter hospital stay (usually 1-3 days versus 5-7 days for surgery)
  • Significantly faster recovery (average of 11 days versus 47 days for surgery)
  • Avoid risks associated with surgical repair
  • Patient cannot receive general anesthesia
  • Patient cannot or does not wish to receive a blood transfusion, which may be necessary during surgery
  • Patient is not a candidate for surgical repair for medical reasons

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Risks Involved in an Abdominal Aortic Aneurysm (AAA) Stent Graft

There are some risks when having an abdominal aortic aneurysm stent graft, but fewer than associated with surgical repair of an AAA. Following are some of the risks:

  • Possible damage to a blood vessel, bruising or bleeding at the puncture site, or infection.
  • Small risk of allergic reaction to the contrast material used during the procedure.
  • The stent graft moves or leaks after treatment making it ineffective. Leaks occur in about 10% of patients and most can be repaired non-surgically.

Scheduling, Insurance and Preparation Scheduling, Insurance and Preparation

Procedure Locations

Consultations for preventative AAA stent grafts are done at RIA Endovascular.

The procedure is performed at the following Radiology Imaging Associates partner hospitals in the Denver, Colorado area:

Call 720-493-3406 to schedule a consultation.

Scheduling

To schedule a consultation to discuss an abdominal aortic stent graft, call 720-493-3406.

  • Medical Center of Aurora
  • Littleton Adventist Hospital
  • Porter Adventist Hospital
  • Sky Ridge Medical Center
  • Swedish Medical Center

Insurance Coverage

Abdominal aortic aneurysm stent grafts are usually covered by insurance. Check with your insurance company to be sure.

Conditions to Let Us Know About

In advance of your exam, let your radiologist or technologist know if any of the following circumstances apply to you:

  • Previous reaction to iodine
  • Previous reaction to anesthesia
  • Coagulation disorder
  • Cardiopulmonary disease
  • Limited kidney function

Preparation Guidelines

Following are the preparation guidelines for abdominal aortic aneurysm stent grafts. You may receive additional or differing guidelines based on your specific situation. Please contact us at 720-493-3406 if you have any questions.

  • Complete a colon prep before the procedure (you will be given specific instructions)
  • Prepare for multi-night stay in the hospital
  • Arrange for someone to drive you to and from the procedure

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What to Expect What to Expect

Before the Procedure

Prior to the date of the procedure, you will undergo pre-procedure exams including an abdominal CT scan and possibly an angiogram. These imaging exams allow the radiologist to see the aneurysm and determine the type and size of stent graft required.

During the Procedure

Abdominal aortic aneurysm stent grafts are performed in a hospital using a fluoroscope to take real-time x-rays of the body.

Here is generally what will happen during an abdominal aortic aneurysm stent graft procedure:

  1. You will change into a gown.
  2. An anesthesiologist will meet and evaluate you.
  3. A nurse will answer any questions you have then start an intravenous (IV) line in your arm. He or she will set up various devices so your heart rate and blood pressure can be monitored throughout the procedure. You may receive general or epidural anesthesia for the procedure.
  4. The site of the groin incision will be cleansed.
  5. A fluoroscope will be moved into position above the abdomen.
  6. The groin incision will be made and the catheter will be inserted into the femoral artery. Using the fluoroscope images, the radiologist will carefully guide the catheter to the location of the aneurysm.
  7. The stent graft will then be deployed through the catheter at the aneurysm site. Once released from the catheter, an angioplasty balloon will be used to expand the stent graft to the appropriate size.
  8. The catheter will then be withdrawn and the incision will be closed and taped.
  9. A CT scan or ultrasound will be done so the radiologist can verify that the stent graft is properly placed.

The procedure takes between two and four hours to complete. You will then spend between one and three nights in the hospital.

After the Procedure

Recovery

Immediately following the procedure, you may have to lie flat for 4-6 hours. You may also be asked to drink extra water to help your body clear the contrast agent used during the procedure.

Some patients may experience discomfort and/or side effects for a few days following the procedure. Side effects include:

  • Swelling of the upper thigh
  • Numbness of the legs
  • Nausea
  • Vomiting
  • Leg pain or throbbing
  • Depression
  • Lack of appetite
  • Absence of bowel movements

Many patients are discharged from the hospital the day after the procedure; however, some require a longer stay. Most people can return to normal activity within two weeks after the procedure.

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Follow-Up

You will need to receive an annual abdominal CT scan or ultrasound to ensure the following:

  • Stent graft has remained in position
  • Stent graft is effectively diverting blood flow from the aneurysm
  • Aneurysm is shrinking

Initial results of AAA stent grafts have been very positive. Since it is a newer procedure, the long-term (10-30 year) data is yet unknown.

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