Interventional thoracic aortic aneurysm repair is a minimally invasive treatment option for thoracic aortic aneurysms (TAA). Depending on your individual needs, your doctor may recommend either:
- Open thoracic aortic aneurysm repair, or
- Endovascular stent-graft repair
St. Joseph's Heart & Vascular Institute is a leader in interventional care. Our cardiologists use the latest digital technology and minimally invasive tools.
What is Interventional Thoracic Aortic Aneurysm Repair?
An endovascular stent graft is composed of fabric supported by a metal mesh called a stent. It can be used for a variety of conditions involving the blood vessels, but most commonly is used to reinforce an aneurysm. The stent graft is designed to seal tightly with your artery above and below the aneurysm. The graft is stronger than the weakened artery and it allows your blood to pass through it without pushing on the bulge.
Preparing for an Endovascular TAA Repair
Before endovascular stent graft repair:
- Your physician will ask you about your medical history and perform a complete physical examination.
- Your physician may also perform several tests, including an electrocardiogram (ECG), a spiral computed tomography (CT) scan, angiography and stress testing.
What to Expect During an Endovascular TAA Repair
- You will usually receive a sedative and a regional anesthesia, or you might receive general anesthesia depending upon your particular circumstance.
- Your vascular surgeon will then cut into the skin overlying the femoral artery in your groin.
- Your vascular surgeon threads a guide wire into your femoral artery and advances it to the aneurysm. Because you have no nerve endings inside your arteries, you will not feel the wires or catheters as they move through your body. You may feel a slight pressure or a sensation of mild tugging during this insertion.
- Using X-rays that appear as moving images on a screen, your vascular surgeon inserts a catheter over the guide wire.
- Usually your vascular surgeon will perform angiography through the catheter to insure correct placement of the endovascular stent graft. You may feel a warm sensation as the contrast dye is injected.
- Your vascular surgeon will insert a compressed form of the graft through a larger catheter, called a sheath The guide wire carries the graft so it can move through your blood vessels. When the graft has reached the aneurysm site, your physician withdraws the sheath, leaving the graft in place. The graft expands to fit snugly against the walls of your artery.
Recovering from Endovascular Stent-Graft Repair
- Usually you will spend two to three days in the hospital.
- During the first recovery day you will be permitted to eat and encouraged to walk.
- After you leave the hospital, you should not drive until your physician gives approval.
- You may be permitted to sponge bathe around your incisions but you should avoid soaking your incisions until they have healed.
- You may also be advised to avoid lifting more than about five to 10 pounds for approximately four to six weeks after the procedure.
- Your physician will instruct you to return for a follow-up visit within the first few weeks after your procedure. At that visit, your physician will check your incisions and assess your overall condition.
Thoracic Aortic Aneurysm Repair (Open Surgical and Endovascular) Follow-Up
For both open surgical and endovascular thoracic aortic aneurysm repair, you will undergo follow-up imaging tests within the first few months after the procedure to ensure that the stent is still functioning without significant problems and in the proper location.
After the first year, you will probably undergo yearly imaging tests if your aneurysm is shrinking and no problems are found. You may require more frequent imaging tests if potential problems require closer monitoring.
Am I a Candidate for Thoracic Aortic Aneurysm Repair?
If your thoracic aortic aneurysm is large or causing symptoms, you need active and prompt treatment. Your doctor may recommend actively treating through open surgical aneurysm repair or endovascular stent-graft repair.
If your TAA is small and not causing symptoms, your physician may recommend "watchful waiting," which means that you will be monitored every 6 months for signs of changes in your aneurysm. Your physician may schedule you for CT or MRI scans every 6 months to watch the aneurysm.
Your doctor will advise you regarding the best option for your particular situation.