An aneurysm is a weakened part of a blood vessel that has started to swell. Over time, the bulge can grow bigger and break (rupture). An abdominal aortic aneurysm (AAA) is a bulge in the part of your aorta that’s in your abdomen.
Aneurysms can be repaired in two ways:
- Endovascular stent grafting, or endovascular aneurysm repair (EVAR), is a way to repair abdominal aortic aneurysms that doesn’t involve open surgery (opening up your abdomen).
It can be done using local anesthetic. It is less invasive, which means it generally has fewer risks and faster recovery. During the procedure, your vascular surgeon makes very small incisions in an artery or vein. Then your surgeon inserts a long thin tube (catheter) to reach the aneurysm with small tools to repair it.
- Open aneurysm repair, or traditional AAA surgery, is done in an operating room while you are under general anesthesia.
Your surgeon opens your abdomen to repair the aneurysm. Then your surgeon connects a long plastic tube (graft) to your aorta to make blood flow around the aneurysm.
You and your surgeon will discuss which surgery is best for you, depending on the location of your aneurysm and your condition.
Bypass surgery is done to treat artery disease. If the artery disease is in your heart, it’s called a heart bypass. If it’s in other parts of your body (peripheral artery disease or PAD), it’s typically called vascular bypass surgery.
Bypass surgery can treat leg artery disease, which is hardening of the arteries in the leg. Surgeons also use bypass to treat arm artery disease, as well as blockages involving blood vessels in other parts of your body.
During surgical bypass, your surgeon creates a detour, or bypass, around the section of the artery that is narrowed or blocked. This lets oxygen-rich blood can flow freely. Surgeons use a graft to make this new pathway for blood. Grafts can be a portion of one of your healthy veins or a man-made tube.
Surgeons use bypasses most commonly to treat leg artery disease, which is hardening of the arteries in the leg. Surgeons also use bypass to treat arm artery disease, as well as blockages involving blood vessels in other locations in the body.
Carotid endarterectomy treats carotid artery disease (CAD), which occurs when plaque builds up in one of the carotid arteries on either side of your neck.
CAD is a serious condition because your carotid arteries supply blood to your neck, head, and brain. If plaque breaks loose, it can travel to your brain and cause an ischemic stroke or a transient ischemic attack (TIA), also known as a mini-stroke.
During a carotid endarterectomy, you will get a local or general anesthetic. Your surgeon makes a cut along the front of your neck and opens your carotid artery. Then your surgeon removes the buildup in your artery. The procedure improves the blood flow and lowers your risk for life-threatening problems.
If you have a blocked artery in your leg, kidney, carotid, or other vessel, your doctor may recommend an angioplasty and stent.
Angioplasty, or percutaneous transluminal angioplasty (PTA), is a minimally invasive procedure done to improve blood flow. During an angioplasty, your surgeon inserts a thin tube (catheter) with a small inflatable balloon on the end into the narrowed section of the vessel. The balloon is inflated. It pushes against the plaque and the wall of the vessel, widening the space for blood flow. The balloon is then deflated and removed.
If needed, your surgeon also places a small metal mesh tube (stent) into the vessel. The stent stays in place permanently, keeping the blood vessel open and blood flowing freely.