The surgeons at North Orlando Surgical Group have a combined total of 45 years of experience offering surgical services to the community. We pride ourselves on providing the least invasive, innovative surgical techniques in an environment focused on quality care and exemplary customer service. Our physicians have performed thousands of hernia repairs with a very low complication rate. We recognize that surgery is a frightening proposition and we pride ourselves in assuring confidence in our abilities while getting you through the process with caring and compassion.
Abdominal aortic aneurysm, or AAA, is a condition where the main artery in the abdomen grows in size. An aneurysm weakens the wall of the artery, placing the patient at risk of rupture. The abdominal aorta is a large artery, with a large volume of blood passing through it. Patients who develop a rupture have less than a 50% chance of making it to the hospital for help. Of these patients that do make it to the hospital, many do not make it through surgery. It is for this reason that once an aneurysm has been identified it is closely monitored. Those that are 5 cm in diameter or greater are recommended to be repaired. The common causes for developing an aneurysm are:
• High blood pressure
• High cholesterol
• Genetic disorders, such as Marfan’s Syndrome
Many patients today are good candidates for an endovascular repair. This is a minimally invasive procedure. An incision is made in each groin to access the femoral arteries. Once the arteries are visualized a small incision is made in the artery wall and a catheter is inserted. Once the catheter is in place a stent is inserted and deployed in the abdominal aorta just below the level of the renal arteries. A second stent is then inserted in the opposite femoral artery and deployed to attach to the main stent, forming one continuous lining from the aorta into the bilateral iliac arteries. The stent that is placed is a woven polyester tube supported by a tubular metal web that is placed inside the diseased vessel without surgically opening the surrounding tissue. After being placed in the artery, the stent graft expands and relieves the pressure on the aneurysm by providing a new pathway for blood flow. Once in place the catheter is removed and the incisions are closed. You can expect to spend the night at the hospital to recover. The next day you will be discharged home and given instructions to call the office for a follow up in four weeks. You are generally clear to resume full activities the next day.
There are a number of benefits to have this surgery:
• The procedure is minimally invasive.
• The procedure can be performed under local anesthesia, if needed.
• There is a lower surgical complication rate.
• The patient may lose less blood during the procedure. This reduces the risk of blood transfusion
• The patient may spend less time in the hospital, resulting in a short hospital stay.
As part of your follow up you will be seen four weeks after the procedure. At that time a follow up CT angiogram will be ordered to evaluate the stent for any issues and you will follow up in our office for those results. If no leaks or issues are found you will then be placed on recall for a yearly repeat CT angiogram. Our office will contact you each year and schedule this test for you, to keep you from having to remember when it is time for your study.
On occasion a patient may be told that they are not, in fact, a candidate for the endovascular approach. This is generally because the aneurysm extends too close to the kidney arteries. In these patients the open approach is the best option for repairing their aneurysm. This involves attaching a bypass graft which is shaped like an upside down Y to the aorta and the two iliac arteries. This graft allows the blood to go around the area of the aneurysm and avoid the risk of rupture. You will have an incision in your abdomen which will be closed using staples. After a few days in the hospital you will be sent home with instructions to follow up in our office in two weeks for staple removal.
Endovascular AAA repair is an excellent treatment to avoid a ruptured AAA. It is important, however, that your surgeon is experienced in this surgery and has the knowledge to perform it safely and effectively. Our surgeons have been performing this surgery for years and stay up to date on all the latest techniques for treating AAA. If you have been advised that you have an abdominal aortic aneurysm, don’t delay in seeking treatment. Call our office for a consultation today!