Abdominal Aneurism RepairAn aortic aneurysm is a bulging, dilation or ballooning in the wall of a claret vessel, usually an avenue, that is due to weakness or degeneration that develops in a portion of the artery wall. Just like a balloon, the aneurysm enlarges, stretching the walls of the artery thinner which compromises the avenue wall'south ability to stretch any farther. At this signal, an aneurysm is at risk of rupturing and causing  potentially fatal bleeding, but as a balloon volition pop when blown upward as well much.

UCSF has a globe-renowned program in endovascular surgery, one of the largest and oldest in existence. Vascular surgeons at UCSF accept extensive experience in performing technically challenging surgeries for complex aortic aneurysms, such as those involving arteries running to the kidneys and intestines, and take pioneered many endovascular procedures for treating aneurysms in apply today.

UCSF Medical Center earned a "high functioning" rating – the highest rating possible – for abdominal aortic aneurysm repair in theU.S. News & World Report 2018-2019 Best Hospitals survey, which evaluated data from more than 4,500 hospitals nationwide.

Abdominal Endovascular Aneurysm Repair (EVAR)

The all-time method to repair an aneurysm depends upon several factors, including the location and shape of the aneurysm likewise equally the concrete condition of the patient. Endovascular grafting is a minimally invasive method to treat an aortic aneurysm. Instead of an open aneurysm repair in which your chest and belly are surgically opened, your surgeon may consider a procedure called an endovascular aneurysm repair (EVAR).

Intestinal aortic aneurysm repair is a procedure used to treat an aneurysm (abnormal enlargement) of the abdominal aorta. Repair of an abdominal aortic aneurysm may be performed surgically through an open incision or in a minimally-invasive process called endovascular aneurysm repair (EVAR). In the EVAR procedure, a stent graft (a material tube supported past metal wire stents that reinforces the weak spot in the aorta) is inserted into the aneurysm through modest incisions in the groin. Endovascular repair of aneurysms does not require a large incision and has a essentially shorter recovery than the conventional open surgical approach. However, non all aneurysms are suitable for endovascular repair.

aneurysm_endovascular repairThe surgeon commencement inserts a catheter into an artery in the groin (upper thigh) and threads it to the aneurysm. Then, using an x-ray to run into the artery, the surgeon threads the graft (also called a stent graft) into the aorta to the aneurysm. The graft is then expanded inside the aorta and fastened in place to form a stable aqueduct for blood flow. The graft reinforces the weakened section of the aorta to forbid the aneurysm from rupturing.

Endovascular Aneurysm Repair

The analogy to the right shows the placement of an endovascular stent graft in an aortic aneurysm. In effigy A, a catheter is inserted into an artery in the groin (upper thigh). The catheter is threaded to the intestinal aorta, and the stent graft is released from the catheter. In effigy B, the stent graft allows blood to flow through the aneurysm.

Endovascular repair reduces recovery time to a few days and greatly reduces time in the hospital. However, surgeons tin can't repair all aortic aneurysms with this process. The location or size of the aneurysm may prevent a stent graft from existence safely or reliably placed within the aneurysm.

Branched Curvation Aneurysm Repair

Aneurysms along the aortic arch are rare and are the most complex to care for, largely because the arterial branches that supply blood to the brain and upper extremities are attached forth the aortic curvation. A customized branched endograft has graft limbs that branch off of the main portion of the device to straight provide blood menstruation to the kidneys, liver, stomach, intestines, and the visceral arteries.

This device is not approved for widespread use in the United States. It tin can only be used under the support of an investigational device exemption from the FDA –this trial is referred to equally the "TAAA trial". The current stage of this report began in 2005, using an industry-made version of the multi-branched stent-graft to treat over 100 patients and so far.

Thoracic Endovascular Aneurysm Repair (TEVAR)

Thoracic aortic aneurysms are those that occur forth the aorta above the diaphragm, the partition betwixt the breast and abdomen, including the ascending aorta, the aortic arch, and the descending thoracic aorta. A thoracic aortic aneurysm is a bulge in the aorta which can cause the aorta'due south bore to balloon to several times its normal size. Such an aneurysm may rupture, leading to extensive internal bleeding that is frequently fatal. TEVAR was initially developed to care for patients who were considered to not be surgical candidates merely is at present considered a suitable alternative to open surgery in most cases.

When treatment becomes necessary for a TAA, medical management is frequently the first option - including reducing claret pressure level, quitting smoking and lowering cholesterol in the patient'southward diet. However, medical management is not considered a "fix" for TAA - it but reduces the stresses on the aneurysm.

Vascular surgeons at UCSF have been pioneers in the field of endovascular aneurysm repair for the abdominal and thoracic aorta. Our principal investigators are as well leadingclinical trials seeking to develop land-of-the-art endovascular devices to advance the treatment of aortic aneurysms.