Aneurysmal Disease

Intervention for arterial aneurysms aims to prevent developing the complications of untreated disease e.g. rupture of an abdominal aortic aneurysm (AAA) that is usually fatal, or a thrombosed popliteal aneurysm that may result in leg amputation.

Abdominal aortic aneurysms may be repaired by open surgery or in some cases by an endovascular approach (EVAR). Open surgery involves direct operative replacement of the AAA with a prosthetic graft whereas EVAR re-lines the aorta under X-Ray control using a fabric-covered stent to ‘exclude’ the AAA from the circulation. AAA surgery is no small undertaking and requires general anaesthetic, extensive abdominal dissection, intensive care support and a longer in-hospital stay. EVAR is associated with much less risk in the short-term but lifelong monitoring is required as sometimes further procedures are needed to ensure continued AAA exclusion. Longer-term, evidence suggests that surgery and EVAR outcomes appear comparable.

Open Surgery for AAA   EVAR for AAA

Popliteal aneurysms are classically treated by surgical ligation and bypass grafting from above to below the diseased arterial segment. In certain situations, endovascular treatment using a flexible covered stent may be considered.