Aneurysm Repair

An aneurysm is a bulging, weakened area of a blood vessel resulting in an abnormal widening or ballooning in its wall. An aneurysm can develop in any blood vessel, but is most often seen in an artery rather than a vein. A common aneurysm location is in the aorta, the main artery of the body, which carries oxygenated blood from the heart to the body.

More than 150,000 Americans are diagnosed with an aneurysm each year. Left untreated, aneurysms (especially aortic aneurysms) can rupture and cause potentially life-threatening complications.

An aneurysm can be treated medically or surgically. At the Aortic Disease Center at Brigham and Women's Hospital (BWH) a multidisciplinary team of experts provides advanced aortic disease care and the latest treatment options, supported by a robust research program.

With 47,000 outpatient visits each year, the Heart & Vascular Center is one of the largest in the United States, treating over 7,000 inpatients and performing more than 8,000 procedures annually at our state-of-the-art Shapiro Cardiovascular Center.

Aneurysm Repair

How Are Aneurysms Treated?
  • Medical treatment - Small aneurysms can be treated medically through medications used to control factors such as hyperlipidemia (elevated levels of fats and cholesterol in the blood) and/or high blood pressure. The patient must be monitored carefully through regular follow-up visits to check for any changes or complications.
  • Open surgical aneurysm repair - Traditional aneurysm surgery is an “open” procedure which requires a large incision and graft. This option is available to most patients. The aneurysmal part of the vessel is replaced with a synthetic graft. Open repair is considered the surgical standard for aortic aneurysm repair. This approach is durable and well-tolerated by most patients. It requires a five- to seven-day hospital stay with complete recovery in four to six weeks, on average.
  • Endovascular (stent-graft) surgical aneurysm repair is performed through a small incision in the groin. This minimally invasive procedure is also called endovascular aneurysm repair (EVAR). With the use of special endovascular instruments and X-ray images for guidance, a stent-graft is inserted via the femoral artery and advanced up to the site of the aneurysm. A stent-graft is a long cylinder-like tube made of thin metal mesh framework (stent), while the graft is made of various materials, such as Dacron or PTFE. The graft material may cover the stent. The stent helps to hold the graft open and in place. Patients generally return home two days after endovascular repair and are monitored in regular follow-up visits to check for any complications. There are certain anatomic requirements for safe placement of an aortic stent graft and not all patients have appropriate anatomy for this procedure.

The type of aneurysm repair depends on the patient’s anatomy, health status and individual needs. For example, a patient who is elderly or has complex medical conditions may not be a good surgical candidate. For this patient, endovascular repair is a viable therapeutic option. Newer approaches to endovascular repair are designed for patients with more challenging anatomy. Previously, these patients were limited to open surgical repair. In some cases, a combined open and endoscopic repair can be used.

Why Have an Aneurysm Repaired?

Left untreated, aneurysms (especially aortic aneurysms) can rupture and cause potentially life-threatening complications. Medical and surgical care is effective and generally well tolerated.

What You Should Expect

The Heart & Vascular Center is located in the Shapiro Cardiovascular Center, across the street from BWH’s main 75 Francis Street entrance. The Heart & Vascular Center brings together the full range of services in one location, fostering seamless and coordinated care for all cardiovascular patients.

Prior to surgery, you will be scheduled for a visit to the Watkins Clinic in the Shapiro Cardiovascular Center for preoperative information and tests.

The day of surgery, your care will be provided by surgeons, anesthesiologists and nurses who specialize in aneurysm repair. After surgery, you will recover in the post-surgical care unit where you will receive comprehensive care by an experienced surgical and nursing staff.

During your surgery, family and friends can wait in the Shapiro Family Center where staff members will provide surgery updates.

Multidisciplinary Care

Patients benefit from the teamwork of cardiac surgeons, vascular and endovascular surgeons, medical cardiologists, interventional cardiologists, cardiovascular imaging experts and radiologists, and anesthesiologists, all experts in cardiovascular disorders. They work alongside nurses, physician assistants, physical therapists, dietitians and social workers to achieve outstanding outcomes for our patients.

Resources

Learn more about cardiac catheterization in our health library.

Visit the Kessler Health Education Library in the Bretholtz Center for Patients and Families.

Access a complete directory of patient and family services.

Learn about the Watkins Clinic in the Shapiro Cardiovascular Center.

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