Endovascular Abdominal Aortic Aneurysm Repair

What you should know

• The aorta is a large artery that runs down the center of your chest and abdomen (stomach). Weakness and stretching of the section of aorta that runs through the abdomen is called an abdominal aortic aneurysm. As an aneurysm grows larger, there is greater risk of it bursting. A burst aneurysm is a very serious medical condition. Endovascular (en-doh-VAS-ku-ler) abdominal aortic aneurysm (AAA) repair is a procedure done to fix the aneurysm in your abdomen.
  
  
• During this procedure, a stent graft (hollow mesh tube) is inserted into your AAA. The stent allows blood to flow normally through your body. It also keeps the pressure of your blood from pushing against the AAA and making it weaker and bigger.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

• During an endovascular AAA repair, you may bleed more than usual, get an infection, or have trouble breathing. The arteries where the catheters were put may be damaged. Your groin may be bruised. The procedure may cause blood clots or air bubbles to be in your blood. These could cause a stroke or a heart attack. Body organs such as your kidneys, lungs, and liver may be damaged and may stop working. Your AAA could rupture (break open) during the procedure. If caregivers cannot fix your AAA with this procedure, they may need to do open surgery.
  
  
• Even after the procedure, your AAA may grow over time. Blood may leak between the graft and the AAA. This may make the AAA grow weaker and larger. It may even cause the AAA to rupture, and you could die. The stent may move out of place, break, or bend and block blood flow. You may get leaks between your aorta and other blood vessels or into your abdomen. Call your caregiver if you are worried or have questions about your procedure, medicine or care.

Getting Ready

The week before the procedure:

• Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you take any herbs, food supplements, or over-the-counter medicines. Tell your caregiver if you have any allergies, including allergies to medicine.
  
  
• Ask your caregiver if you need to stop taking any other prescribed or over-the-counter (OTC) medicine before the procedure.
  
  
• Ask your caregiver if you need to take antibiotics before the procedure. This is medicine that fights infection.
  
  
• You may need blood tests before your procedure. Talk to your caregiver about these or other tests you may need. Write down the date, time and location for each test.

The night before the procedure:

• Ask caregivers about directions for eating and drinking.
  
  
• If you have diabetes, ask your caregiver for special instructions about what you may eat and drink before your surgery. If you use medicine to treat diabetes, your caregiver may have special instructions about using it before surgery. You may need to check your blood sugar more often before and after having surgery.

The day of the procedure:

• Write down the correct date, time, and location of your surgery.
  
  
• Ask your caregiver before taking any medicine on the day of your procedure. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring a list of your medicines or the pill bottles with you to the hospital.
  
  
• Do not wear contact lenses the day of your procedure. You may wear glasses.
  
  
• An anesthesiologist will talk to you before surgery. This is the caregiver who gives you medicine before and during the procedure. The medicine the anesthesiologist gives you will make you unable to feel or remember the procedure.
  
  
• You will be asked to sign a legal piece of paper (consent form). It gives your caregiver permission to do surgery. It also explains what may happen during the procedure, and your choices. Be sure all your questions have been answered before you sign this form.

Treatment

What will happen:

• You may be given medicine in your IV to make you drowsy or go to sleep. Caregivers will use special soap to clean the skin on your abdomen and both sides of your groin. Your groin is the area where the top of your leg meets your abdomen.
  
  
• Caregivers will make an incision (cut) on each side of your groin. A sheath (long hollow tube) is put through your skin and into the artery (blood vessel) inside the groin. The sheath allows caregivers to insert different catheters into the artery during the procedure. A catheter with a stent graft (mesh tube) is threaded through the sheath and into your AAA. Your caregiver will do x-rays or other tests to take pictures of your AAA and graft during the procedure. Dye is injected through a catheter so that your AAA and graft show up better in the pictures. The stent graft is flat while caregivers thread it into the AAA. Once inside the AAA, the stent graft is opened up with a balloon-tipped catheter.

After the procedure:

You are taken to the recovery room or a postanesthesia care unit (PACU). Caregivers will watch you very closely. A bandage is used to cover the area where the catheter went in. This bandage keeps the area clean and dry to prevent infection. A caregiver may remove the bandage shortly after the procedure to check for bleeding or bruising. Do not get out of bed until your caregiver says it is OK. When caregivers feel that you are ready, you will be taken to your hospital room.

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Contact a caregiver if

• You cannot come to your appointment on time.
  
  
• You have a fever.
  
  
• The problems for which you are having the procedure get worse.
  
  
• You have questions or concerns about the procedure.

Seek Care Immediately if

• You have chest pain or trouble breathing all of a sudden.
  
  
• You have blood in your BM.
  
  
• You have any of the following signs and symptoms:
  
  
  • Sudden, bad pain in your abdomen, back, or side. The pain may travel down to your legs, hips, and groin.
    
    
  • Fast heart beats in your chest, or you can feel heart beats in your abdomen.
    
    
  • When you touch your abdomen, it feels hard and tight.
    
    
  • Nausea (feel sick to your stomach) and vomiting (throwing up).
    
    
  • Pale, clammy (sweaty) skin. You suddenly become weak or faint, or feel afraid that something is very wrong inside your body.
    
    
  • This is an emergency. Call 911 or 0 (operator) to have an ambulance take you to the nearest hospital or clinic. Do not drive yourself!

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.