Aortic Aneurysm Repair
OHSU vascular surgeons can repair abdominal (stomach), thoracic (chest) and thoracoabdominal (both) aneurysms with open and endovascular (stent graft) techniques.
Aneurysm open repair
Open repair of an aortic aneurysm involves an incision to directly visualize the aortic aneurysm. The procedure is performed in an operating room under general anesthesia, and the aneurysm is repaired by the use of a long cylinder-like tube called a graft. Grafts are made of various materials, such as Dacron (textile polyester synthetic graft) or polytetrafluoroethylene (PTFE, a non-textile synthetic graft). The graft is sutured to the aorta connecting one end of the aorta at the site of the aneurysm to the other end of the aorta.
Endovascular aneurysm repair (EVAR)
EVAR is a minimally-invasive (without a large incision) procedure performed to repair an aortic aneurysm. EVAR may be performed in an operating room, radiology department, or a catheterization laboratory. The physician may use general anesthesia or regional anesthesia (epidural or spinal anesthesia). The physician makes a small incision in each groin to visualize the femoral arteries in each leg. With the use of special endovascular instruments, along with x-ray images for guidance, a stent-graft is inserted through the femoral artery and advanced up into the aorta to the site of the aneurysm. A stent-graft is a long cylinder-like tube made of a thin metal framework (stent), while the graft portion is made of various materials such as Dacron or polytetrafluoroethylene (PTFE) and may cover the stent. The stent helps to hold the graft in place. The stent-graft is inserted into the aorta in a collapsed position and placed at the aneurysm site. Once in place, the stent-graft is expanded (in a spring-like fashion), attaching to the wall of the aorta to support the wall of the aorta. The aneurysm will eventually shrink down onto the stent-graft.