Endoluminal (or Endovascular) aneurysm repair involves insertion of stents through the arteries in the groins on both sides. The stent is inserted into the aneurysm and the artery is ‘re-lined’ on the inside, so as to divert blood down into the stent and into the legs, rather than into the aneurysm. This allows the aneurysm to be ‘de-pressurised’ to drastically reduce the risk of it bursting. This procedure is usually done under general anesthesia but very occasionally can be done under local/regional anaesthetic if necessary. After your anaesthetic, a small incision (about 1cm) is made in the groins to allow for the insertion of stent under ultrasound guidance. Occasionally, if the arteries in the groin are narrow or blocked due to buildup of plaque, Mr. Bhamidi may make a larger (~5cm) incision in the groin to access the artery to allow the stents to be inserted into the artery under direct vision.
The main stent body is inserted from one side, while the extension piece is inserted from the other side so that the stent ends up with ‘trouser’ configuration diverting blood flow from the aneurysm into both legs. The procedure usually take between 2 to 3 hours and involves a hospital stay of 2 to 3 days. Once discharged after a successful procedure, it is very important to ensure that the stent is regularly monitored. A post-operative review and a CT scan will be organised within a month of your operation (or sooner if indicated) to ensure everything is going well. 10-20% of Aortic stents can develop some sort of minor problems or issues that require some further treatment, hence the need for regular scans and check-ups. Regular scans are done every 6 to 12 months in the first few years after treatment, following which the scan intervals are spaced out, provided no problems have been identified during the previous couple of years.