How Long Is Recovery From Repair Of Aneurysm With Endovascular Stent Near Heart?

Overview

A thoracic aortic aneurysm, an abnormal burl in a weakened wall of the aorta in the chest area, can cause a variety of symptoms and frequently life-threatening complications. Due to the serious risks it presents, timely diagnosis and treatment of a thoracic aneurysm are critical.

The standard surgical handling for thoracic aortic aneurysms is open-chest aneurysm repair, but Cleveland Clinic surgeons are at present able to care for many thoracic and thoracoabdominal (occurring in the lower office of the thoracic aorta and the upper part of the abdominal aorta) aneurysms with a minimally invasive procedure called an endovascular stent graft.

What is an endovascular stent graft?

Endovascular means that surgery is performed inside your aorta using thin, long tubes called catheters. Through small incisions in the groin, the catheters are used to guide and evangelize a stent-graft through the blood vessels to the site of the aneurysm. The stent graft is then deployed in the diseased segment of the aorta and "relines" the aorta like a sleeve to divert claret catamenia away from the aneurysm.

An endovascular stent graft is a fabric tube supported by metallic wire stents (likewise called a scaffold) that reinforces the weak spot in the aorta. By sealing the area tightly with your artery above and below the aortic aneurysm, the graft allows claret to pass through it without pushing on the aneurysm.

Who is a candidate for endovascular repair of a thoracic aneurysm?

You may be eligible for endovascular stent grafting if your thoracic aneurysm has not ruptured and the aneurysm is 5 centimeters or more than in size.

Your physician tin determine if aortic aneurysm repair is the all-time treatment by performing one or a combination of imaging studies, which may include:

Loftier resolution, computed tomography (CT) scan
Magnetic resonance imaging (MRI)
Angiography (an x-ray of the blood vessels)
Transesophageal echocardiography (TEE), to record ultrasound images of your centre from within your esophagus, or food pipe
Intravascular ultrasound

Physical characteristics of the aorta and the aortic aneurysm itself are very important in determining if endovascular aorta repair is the best treatment.

Procedure Details

What happens during endovascular stent grafting?

Your surgeon will brand small-scale incisions in the skin above the femoral artery (the large avenue that supplies claret to each leg) in the groin. A guide wire is threaded through the avenue beyond the area of the thoracic aneurysm.

Past using x-ray guidance, your surgeon inserts the device over the guide wire. The stent-graft device is constrained within a catheter to arrive easier to evangelize the stent-graft through your claret vessels. One time the graft is guided to the thoracic aneurysm site, the catheter is withdrawn, exposing the stent-graft in identify. The stent-graft and so expands like a bound to fit confronting the walls of the aorta on either side of the aneurysm, and delivers claret flow through the weakened section.

One time the stent-graft is in place, the blood flows through the graft, avoiding the aneurysm. Over fourth dimension, the aneurysm typically shrinks due to the blood pressure level being diverted away from the aneurysm.

CT showing a thoracic aortic aneurysm before surgery

CT showing a thoracic aortic aneurysm before surgery:

red arrow: left subclavian artery
yellow pointer: left common carotid artery
dark-green arrow: proximal extent of thoracic aortic aneurysm

Thoracic aorta stented red arrow: stent within the proximal subclavian artery yellow: stent in left common carotid artery

Thoracic aorta stented

red arrow: stent inside the proximal subclavian avenue
yellow: stent in left mutual carotid artery

Cleveland Clinic surgeons are also using fenestrated and branched endografts to care for more complex thoracic aneurysms involving the aortic curvation and thoracoabdominal aneurysms (those which involve the aorta both in the chest and the abdomen). Additionally, branched and fenestrated grafts are used to extend thoracic grafts to repair those aneurysms that involve the vessels leading to the intestines or the brain and arms.

Digital CT showing endovascular stenting of an abdominal aortic aneurysm with bilateral iliac aneurysms

Digital CT showing endovascular stenting of an abdominal aortic aneurysm with bilateral iliac aneurysms, using a techniques that preserves menses into both internal iliac arteries (majestic arrows)

For those patients with extensive aortic or multiple aneurysms, the all-time arroyo may crave a combination of open surgery and endovascular repair. This combined therapy is referred to as a hybrid approach and virtually oftentimes includes what is known every bit an elephant trunk procedure.

Risks / Benefits

What are the risks of endovascular repair of thoracic aneurysms?

Although endovascular surgery reduces recovery fourth dimension to a few days, there are still potential risks. The possible complications of endovascular repair include:

Leaking of claret around the graft, known equally "endoleak"
Motion, or migration, of the graft away from its initial placement
Stent fracturing

Boosted complications that are rare just serious include:

Paralysis
Delayed rupture of the aneurysm
Infection

Your surgeon will discuss the benefits and potential risks of the process with you lot.

Larn nearly our Surgical Outcomes

The long-term durability of endovascular stent grafting to care for a thoracic aneurysm is yet unknown because this is a adequately new procedure. For this reason, patients who have endovascular repair of their thoracic aneurysms must exist monitored closely on a regular basis with examinations and imaging studies.

What are the benefits of endovascular repair?

Endovascular repair of thoracic aneurysms is generally less painful and has a lower risk of complications than traditional surgery because the incisions are smaller. Endovascular aorta aneurysm procedures also permit you to go out the infirmary sooner and recover more apace after your aorta repair.

Recovery and Outlook

How long will it take to recover from endovascular repair of a thoracic aneurysm?

Your infirmary stay following endovascular stent grafting is usually 2 to 3 days. While your recovery will take less fourth dimension than recovering from open-chest thoracic aneurysm surgery, the early restrictions are similar and include:

No driving until canonical past your doc (usually within one-2 weeks afterwards the procedure, and no longer taking pain medication)
No baths until the groin incisions heal; showers and sponge baths effectually the incision are permitted
Avoid lifting more than 10 pounds for approximately 4 - vi weeks after the procedure

You lot will return for a follow-upward visit within one month of the procedure. Follow-upwardly imaging tests will take place one and vi months following the procedure to make certain the stent is still functioning and in the proper location. If y'all aneurysm is shrinking and no issues are institute, your subsequent imaging tests will take place yearly.

After you've had an endovascular repair of an aneurysm, it is recommended you prefer the same heart-healthy lifestyle led by other heart surgery patients. Your health care team can provide more data.