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Minimally Invasive Endovascular Aneurysm Repair


Aortic Stent graft versus conventional open surgery

Endovascular Aneurysm Repair (EVAR)


The development of endovascular stent graft surgery of abdominal aortic aneurysms avoid both painful and high risk than the traditional thoracic surgery, this procedure is one of endovascular surgery.


First, having a complete diagnostic assessment (usually via MRI and angiography) of pattern, size and location of aortic aneurysm before the surgery in order to choose the most appropriate stent graft for the patients. Using x-rays to see the exact location of the aneurysm, the surgeon will introducethe delivery catheter through the  vessel in your thigh (common femoral  artery) to the aneurysm site in the abdomen.


The stent graft is slowly deployedfrom the delivery catheter into the aorta. As the stent graft is released, it expands to the proper size so that it fits into the aorta both above and below the aneurysm. In this way, there is no active blood flow in aneurysm and the risk of rupture has been reduced.


















Conventional open surgery of abdominal aorta surgery usually separate, cut and suture a large vessel which needs to be treated by large chest incision, it often requires extracorporeal for the heart and blocks the blood flow for some time to the aorta in order to proceed the surgery.


Advanced endovascular surgery proceed via wires, catheters and stent graft into vessels, and completes the treatment by angiography, so there is no actual vessel peeling or sewn, the advantages for endovascular surgery are small wound, less blood loss, less pain and quicker recovery advantages of minimally invasive.


There are advantages to treating abdominal aortic aneurysm with endovascular stent graft compare with traditional surgery. First of all, the surgery wounds are on both sides of thigh, a small wound or puncture wound (even if vessel closure system is used, there is no need to proceed with incision) and no longer need for a more than thirty centimeters chest wounds, so, of course, after the surgery, the recovery time considerable progress, no longer the same as the conventional open surgery to stay in ICU for a few days. In general, patients can be discharged on the same day or a few days after surgery, not like patients who need two weeks for more frequently hospitalized when they have conventional open surgery of abdominal aortic aneurysm. 


Secondly, the amounts of blood loss during surgery, surgery-related cardiopulmonary complications, hemiplegia, and surgery-related mortality also have significant differences.


The arbitrary setting of a single threshold diameter for elective abdominal aortic aneurysm repair applicable to all patients is not appropriate, as the decision for repair must be individualized in each ease.

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