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Abdominal Aortic Aneurysm Repair

An abdominal aortic aneurysm (AAA) is a bulging, weak point in the aorta - the main trunk of the arterial system.

The condition potentially is life threatening - if the aneurysm bursts and is not treated immediately, mortality is nearly 100 percent. Not all aneurysms require treatment: the size of the aneurysm and the age and health of the patient are factors that weigh on treatment options.

An abdominal aortic aneurysm typically occurs in the area near the pelvis and above the branching of the aorta to the legs.

There are two methods of treatment: open repair and endovascular aneurysm repair (EVAR).

In open repair, a large incision is made in the abdomen to expose the aorta and a graft is used to repair the aneurysm.

EVAR is a newer, far less invasive procedure. The surgeon makes a small incision in the groin and inserts special instruments through a catheter. The doctor guides the delivery catheter carrying the abdominal aortic aneurysm (AAA) stent graft to the site of the weakened artery.

Once the AAA stent graft is in position, the surgeon fastens it in place and removes the delivery catheter.

Robert Bennett, M.D., board-certified cardiovascular and thoracic surgeon with Community Medical Associates, performs both methods of treatment. He prefers EVAR when the patient qualifies for the procedure.

Depending on the situation, the procedure may be done using regional anesthesia rather than general anesthesia. Recovery from EVAR is much faster than recovery from an open procedure. EVAR patients often leave the hospital the next day and return to normal activities in four-to-six weeks. With open surgery, the hospital stay may be up to 10 days and it may take three months to return to normal activities.

A patient must have the appropriate anatomy to qualify for EVAR. Following surgery, the patient will be monitored by CT scans every six months to ensure the stent-graft has not shifted out of place.

Each year, some 40,000 people in the United States undergo elective AAA repairs. Men are more likely to require the surgery. Smoking is a clear risk factor. The typical age is over age 65, but it can occur in younger people, women, and those who do not smoke.

Medicare pays for a one-time screening for AAA if you have Medicare Part B insurance, are considered at risk, and have a physician referral for the test. You are considered at risk if you have a family history of AAA or if you are a man age 65-75 who smoked at least 100 cigarettes during your life.

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