EndoVascular Aneurysm Repair
Why have I been offered this operation ?
You have an abdominal aortic
aneurysm which is large enough to carry a real risk of rupture,
which most people do not survive. Your surgeon has looke dat the
options and after discussion with you, it has been decided that an
endovascular or keyhole operation is the best way of treating
What does it involve ?
It will require a general anaesthetic, and then the surgeon will
make an incision in your
What tests will I need ?
You should have already had most of the tests in order to make
the decision about the best operation. We need a CT scan to see the
anatomy of the aneurysm, and an exercise test of your heart and
lungs (CPET or similar). There will be some last minute blood tests
prior to surgery to make sure you are not anaemic and your kidneys
are working well, and also to
What are the risks ?
Even with the best preparation, some patients' hearts may
struggle with the stres of any operation, particularly if they have
previous symptoms of angina or heart attack, or the operation is a
long or difficult one. As a result, the main risk is of you having
a heart attack, about 4%. Less commonly, the kidneys shut down
temporarily due to changes in blood pressure or the dye used to
check the operation, and a small number of patients (about 1%) need
an artifical kidney for a few days. Some operations run into
problems with bleeding, and this increases the risk of both kidney
and heart complications, as well as the rare need for a second
There are other risks associated with any general anaesthetic
and any operation such as chest or wound infection, DVT, difficulty
passing water postoperatively, but precautions are routinely taken
The question most patients want answered is the risk of dying
associated with the operation. This is about 2%, from all possible
causes but predominantly heart problems. Your surgeon should
discuss these risks with you in the clinci, particularly if your
risks are above average, as well as reviewing them just before the
What will happen in hospital ?
You will be admitted the day before or on the day of surgery.
You should not eat or drink from midnight on the day of the
operation. You will be seen by the surgical team and sign the
consent if not already done, and the anaesthetist will see you to
explain about going off to sleep. The ward staff will help you
change into a theatre gown, and you will be taken to the
anaesthetic room in the theatre department. You will have a needle
in the back of your hand and the anaesthetic team will put in other
drips and monitoring including a urinary catheter.
After the operation you will go to the recovery suite, and
remain there for a couple of hours until the team are happy to move
you back to the ward. Some patients remain on the Extended Recovery
Unit in the recovery bay overnight or occasionally the High
Dependency Unit for closer monitoring.
You can eat and drink as soon as the surgical and anaesthetic
team are happy that all is well postoperatively, usually within a
couple of hours. The drips and catheter will be removed as you
begin to mobilise, you will get a bit of discomfort and perhaps
some bruising in the groins but you should be walking to the
bathroom and around the ward the day after surgery and most people
are ready to go home by about 4 days. Some patients get backaches
after the operation, we think this is due to the aneurysm sac
closing off. It usually settles after a couple of days and simple
pain killers are effective.
What will happen after I am discharged ?
You will feel a little tired and may get some discomfort in the
groins but it should be only a couple of weeks before you are back
to your usual level of activity. Take it steadily and don't overdo
Will I need following up ?
We will see you in the clinic at 6 weeks to check that you are
pretty much back to normal, and the wound is healed well. About a
quarter of patients are still on the mend at this stage,
particularly patients over 75. With this operation, the chance of
late complications is very small, and so we don't routinely need to
review you after this.