Treatment for an abdominal aortic aneurysm (AAA) depends on:
- the size of the AAA
- how fast it gets bigger
- if you have other health problems
Large AAAs are more likely to burst (rupture). Your doctor will usually recommend surgery to stop this happening.
Ask your doctor if you're not sure what size your AAA is.
Large AAAs
If you have a large AAA, your doctor will usually recommend surgery. This is because the risk of the AAA bursting is bigger than the risk of complications from surgery.
The surgeon replaces the weakened section of aorta with an artificial tube called a graft.
The 2 main types of surgery are:
- endovascular surgery - the graft is inserted into a blood vessel in your groin and passed up into the aorta
- open surgery - the graft is placed in the aorta through a cut in your tummy
Both types of surgery reduce the risk of an AAA bursting. Talk to your surgeon about types of surgery. They can explain the advantages and disadvantages. You can discuss which option is best for you.
If surgery is not suitable for you, you will have regular scans to monitor your AAA.
Your doctor will give you advice on lifestyle changes. They may also prescribe medicines to treat high blood pressure or high cholesterol.
Endovascular surgery
You can have endovascular surgery under:
- general anaesthesia - you are not awake for the operation
- regional or local anaesthesia
Your surgeon will:
- Make small cuts in your groin.
- Insert a graft into a blood vessel in your groin.
- Guide the graft into the aneurysm. They use x-rays to make sure the graft is in the right place.
- Divert the blood flow through the graft. This blocks blood flow into the aneurysm.
- Check that there are no leaks around the graft.
- Stitch the cuts and put on a sterile bandage or dressing.
Most people stay in hospital for 2 or 3 days after the operation. But it can take a few weeks or months to fully recover.
Advantages and disadvantages of endovascular surgery
The advantage of endovascular surgery is a quick recovery time. The risk of complications is generally lower than with open surgery in the short term.
A disadvantage of endovascular surgery is that you need regular scans after surgery. This is to make sure the graft has not moved and no blood leaks into the aneurysm. If your doctor sees a problem during a scan, you may need another operation.
Risks of endovascular surgery
As with any operation, there are possible complications and risks. Your surgical team and anaesthetists will explain the risks to you.
They can include:
- severe bleeding (haemorrhage)
- blood clot blocking an artery to your leg or legs
- heart attack
- stroke
- wound infections
- chest infection
Open surgery
You have open surgery under general anaesthetic.
Your surgeon will:
- Make a large cut in your tummy.
- Replace the part of the aorta with the aneurysm using a graft.
- Close the cut with stitches and put on a sterile bandage or dressing.
Most people stay in hospital for 7 to 10 days after the operation. It may take months to fully recover. But in younger and healthier patients open surgery may be a better option in the long-term.
Advantages and disadvantages of open surgery
The risk of graft problems is lower than with endovascular surgery. The graft usually works well for the rest of your life. Most people do not need regular scans to check it.
The risk of complications is generally higher than with endovascular surgery. The hospital stay and recovery time is often longer.
Risks of open surgery
As with any operation there are possible complications and risks. Your surgical team and anaesthetists will explain the risks to you.
Risks of open surgery include:
- a wound infection or infection of the graft
- a blood clot
- severe bleeding (haemorrhage)
- a heart attack or stroke
- erectile dysfunction or ejaculation problems in men
Treatment for a burst AAA
A burst aneurysm is a medical emergency. Treatment is emergency surgery.
The surgeon will decide if open or endovascular surgery is the best option.
Content supplied by the NHS and adapted for Ireland by the HSE
