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What is Endovascular Surgery?

By Jacquelyn Gilchrist
Updated May 17, 2024
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Endovascular surgery is a minimally invasive procedure designed to treat abdominal or thoracic aneurysms. These aneurysms are weakened or swollen areas of a major blood vessel called the aorta. This surgery uses small incisions to access the blood vessel, which shortens recovery time and results in less discomfort than surgeries that require larger incisions. Candidates for endovascular surgery must have an aneurysm that is located in a place where the surgeon can access it with small instruments.

Preparation for endovascular surgery will include a physical exam and lab testing. The doctor will check the condition of the patient's heart with a stress test or an electrocardiogram (EKG). He will also use imaging tests to determine the exact location of the aneurysm. The patient must disclose his full medical history, including other medical conditions he has and medications he takes. Certain medications or supplements may need to be discontinued for a time prior to endovascular surgery, such as blood thinners and aspirin.

This operation is often performed under local or regional anesthesia, so that only a certain area of the patient's body is numbed. Those who are anxious about the surgery may request a general anesthesia to put them to sleep. If they do so, they must refrain from eating or drinking for a period of time prior to the surgery. To begin an endovascular surgery, the hip area will first be sterilized and a small incision will be made in the same location.

The surgeon will insert an instrument called a guide wire into the incision and into the blood vessel. It will be guided to the aneurysm and a catheter will then be inserted over the guide wire. The catheter is used as a sort of transportation device, as it is responsible for carrying a graft directly to the aneurysm. This graft is released at the site of the aneurysm, where it then expands to block blood flow, thereby allowing the aneurysm to gradually shrink. Instead, the blood will flow through the graft, which is left in place permanently.

Typically, patients may expect to stay overnight at the hospital for a total of two to three days. They will be able to walk and function normally on the day after an endovascular surgery, however most people report fatigue and general malaise for the first two weeks. When the patient is released from the hospital, he must be careful to get plenty of rest and follow the surgeon's exact instructions. Although sponge baths are permitted, the incision area must remain dry as it heals. Normal activities are usually resumed after four to six weeks.

Some complications are possible with an endovascular surgery. Patients should be aware that infection, blood flow blockage, and graft malfunction may occur. Some people may experience a depressed immune system, which is accompanied by a fever. Rarely, the aneurysm may rupture and the kidneys may become damaged. A burst artery, impaired circulation to the lower body, and paralysis are also rare complications.

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