Abdominal Aortic Aneurysm

Advanced Vascular Surgery

We are dedicated to providing exceptional and comprehensive care for Abdominal Aortic Aneurysm (AAA) and Thoracic Aortic Aneurysm (TAA) in the Western Michigan area. We work at state of the art hybrid operating suites in the Kalamazoo area hospitals. We are founders of the Regional Aortic Center of Excellence, which has established a multidisciplinary approach and coordinated patient centered care for best outcomes.

What is AAA

What is AAA

The aorta is the largest artery in the body. It starts in the heart,
travels through the chest, (thoracic aorta), and through the abdomen,
(abdominal aorta). At the level of the umbilicus, (belly button), this
artery divides.
An aneurysm is a bulging or ballooning of an artery. It can form at any level in the aorta. This results in weakened walls that can rupture without warning. If rupture occurs, massive bleeding results and if left untreated death follows. AAA's are the tenth leading cause of death in men over 50 in the US, with ruptures accounting for approximately 20,000 deaths each year. Repair of an aneurysm is done by replacing the aorta with a bypass graft or by inserting a 'stent graft' within the vessel.

Symptoms

Symptoms


  • Abnormal Forceful Pulse - This is felt just above the umbilicus. A trained professional can feel and measure the approximate diameter of this artery.

  • Back Pain - Occasionally, a person will experience a new onset of back pain, which can be moderate to severe, and is not explained by back injury.

  • Most often, there are no symptoms and the aneurysm is discovered during a routine physical examination or when CAT Scan or MRI are done for a different ailment. AAA runs in families and occurs more often in older patients.

Diagnosis

 

    • A complete physical examination.
 
    • Ultrasound testing -This is a painless test that allows the physician
      to view the aorta and measure its diameter, this test is routinely
      performed in the office.
 
    • CAT Scan of the Aorta - CAT Scans are usually performed in a hospital setting and may require IV dye infusion.
 

Treatment

Medical Management

This consists of monitoring a small aneurysm using ultrasound every 6-12 months. If an increase in the diameter occurs, then an operation may be required. We will emphasize smoking cessation, healthy living, blood pressure control and lipid management.

Surgical Management

There are two surgical options for the treatment of AAA, open surgical repair, and minimally invasive endovascular aneurysm repair (EVAR). Generally, surgical repair is recommended for aneurysms based on size, growth and other associated factors.

Open Surgical Repair of AAA

Open surgical repair of the AAA involves an abdominal incision to gain access to aneurysm. The aneurysm is opened and a graft is sutured into the proximal and distal ends of the aorta or aortic branches. The dilated portion of the aorta is then closed over the graft.

Endovascular Aneurysm Repair (EVAR)

Endovascular Aneurysm Repair (EVAR) is a minimally invasive alternative to open surgical repair. This procedure involves small incisions in the groin to allow for insertion and positioning of an endovascular stent graft at the location of the aneurysm.
Benefits of EVAR include significantly shorter hospital stays, and lower risk for peri-operative death. At Advanced Vascular Surgery we are leaders in endovascular innovation and are able to offer minimally invasive endovascular repair of all segments of the aorta.

Risks of Operation

Risks of open surgical repair of the aorta include bleeding, infection, prolonged hospitalization, bowel dysfunction, bowel injury, renal failure, myocardial infection, stroke and death.

Risks of endovascular stent graft repair include bleeding, infection, renal failure, risks of conversion to open aneurysm repair.