What is Aortic Stenting?
Aortic stenting is one of the treatment methods to prevent aortic rupture. This involves placing a stent-graft, a fabric covered metal tube, inside the aorta to depressurize the aortic sac and prevent it from rupturing.
Not all patients with aortic aneurysms will require intervention. The usual indications when an intervention should be offered include:
- Abdominal aorta greater than 5.5cm in widest diameter
- Rate of growth of aorta greater than 5mm in 6 months
- Symptomatic aneurysms
Generally, younger patients less than 55 to 60 years of age with good risk factors should consider an open surgical repair as it is more durable in the long run. For older patients who have more medical problems, the option of aortic stenting is recommended as the operative mortality and morbidity is less.
The surgery is performed under General Anesthesia. In high-risk patients, the surgery can also be done under a Local Anaesthetic with monitored sedation.
- Incisions are made in both groins and the femoral arteries are identified.
- Sheaths are placed into the femoral arteries to allow access into the vessels.
- Catheters and wires are placed via these sheaths into the aorta.
- Contrast agent is injected into the aorta to visualise the aorta and its branches clearly.
- The aortic stent-graft is delivered from the femoral artery into the aorta.
- Once the position is satisfactory, the stent-graft is deployed and the delivery device removed.
- The femoral artery incisions are repaired and the wounds closed with sutures.
You may have to spend 2 to 3 days in the hospital because your surgeon will want to make sure that the stent operates correctly. You will most likely be able to eat on the first day, and you may be up walking. Your physician will give you instructions for your return home. Recovery time is usually shorter for an endovascular procedure than traditional surgery. Your physician may instruct you to:
- Avoid driving until you are cleared by your physician;
- Avoid bathing until the incisions are healed; you may be able to shower or take sponge baths; and
- Avoid lifting anything over 10 pounds for 4 to 6 weeks after the procedure.