When is an Open Repair Necessary for an Abdominal Aortic Aneurysm (AAA)?

Published on: June 7, 2018

An abdominal aortic aneurysm or AAA occurs when there is a weakened area on the wall of an aorta located in the abdomen. If not treated, an AAA can rupture, causing internal bleeding and even death. When an AAA is diagnosed or identified, there are two main types of treatments that are typically used if there is a higher risk of rupture: endovascular aneurysm repair (EVAR) and open repair. While EVAR has less risk and is minimally invasive, in some cases an open repair or open surgery is needed.

Open repair for AAA is the standard procedure for treating this condition in an emergency. While EVAR has fewer risks during surgery due to the smaller incision and stress on the patient, it is not always the best choice. Some studies suggest that while EVAR has lower risks during surgery, an open repair may have improved long-term results for certain patients with AAA.

Since AAA can put the health and life of a patient at risk if there is a rupture, it is important to understand the benefits of both types of aorta aneurysm repairs. Both open repair and EVAR are used to strengthen the aorta, usually with grafting. However, circumstances that may require an open repair can include:

  • When there has been an aorta rupture
  • There is internal bleeding from AAA
  • The aneurysm is larger than 2” in diameter
  • There is a higher risk of rupture – risks of rupture outweigh the risks of open repair surgery
  • The growth rate is more than 1 cm per year

For anyone with an AAA, it is important to discuss the options with a vascular surgeon to determine if open repair is necessary. It can be a life-saving treatment option in many cases, outweighing the risks of surgery.

Posted on behalf of:
Alan Benvenisty, MD
1090 Amsterdam Avenue
New York, NY 10025

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