The primary goal of AAA monitoring program is to prevent an aneurysm from rupturing. If the diameter of aneurysm reaches 5.0-5.5 cm, treatment should be considered.
AAA monitoring: if your abdominal aortic aneurysm is small < 5.0 cm and you don't have symptoms, close monitoring is advised. You will have regular appointments and an ultrasound of the AAA, usually every six months, to check if it is growing. In addition, your doctor may advise certain lifestyle changes and risk factor to avoid progression and potential rupture.
Our vascular specialists generally recommend surgical repair if your aneurysm is 5.0 cm or larger, or if they believe it is growing relatively quickly between two visits. In addition to the size and rate of growth, our vascular specialists may recommend surgery if you develop symptoms such as stomach pain or if you have a tender or painful aneurysm.
Depending on the size, anatomy, CT scan appearance of your abdominal aneurysm, and your overall health, our vascular surgeons may recommend one of two modalities to repair your aneurysm:
1. Endovascular repair (EVAR): This less invasive procedure is currently used in approximately 60-70% patients. A synthetic graft is attached to the end of catheter that is inserted through the arteries in your groins and threaded into the weakened area of the aorta where it is delivered and deployed, effectively sealing your aneurysm and excluding it from the circulation. With time, the aneurysm is likely to shrink, and rupture of the aneurysm is avoided. This requires continued monitoring off the aorta on a regular basis to identify any potential leakage form the seal
2. Open abdominal surgery: involves removing the damaged section of the aorta completely and replacing it with a synthetic tube (graft), which is sewn into place. This modality requires longer hospitalization and although it is a safe and durable treatment in otherwise healthy patients, it can be challenging in patients with poor heart or lung capacity
Which method is better suited for my AAA?
It is now clear that long-term survival rates are similar for both endovascular surgery and open surgery. The endovascular repair is less invasive but requires continued monitoring. The open repair is more invasive during and immediately following the repair but requires minimal long-term monitoring beyond the usual vascular health exam.
At South Charlotte General and Vascular Surgery, our vascular specialists work very closely with your primary doctors to screen, monitor and repair your AAA, if the time comes when such repair is needed. They will discuss with you the indications, risks and benefits as they present you with a treatment plan, so you can be well informed and make the decision that is right for you. Request an appointment online here.