Making this decision is presently very difficult since AAAs afflict mainly those over 60 years of age . The standard surgical procedure to repair an AAA involves a large abdominal incision. Recently, vascular surgeons at UPMC have used a minimally invasive procedure called endovascular surgery in which the aneurysm is repaired from inside the aorta using a cathether. The cathether contains a collapsed polyester tube which is inserted into the patient's femoral artery and moved to the site of the aneurysm. Once inside the aneurysm, a spring-type attachment system hooks the tube to the inside walls of the artery on either end of the aneurysm and is anchored into place.
Blood then flows through the implant, effectively depressurizing the aneurysm.
Endovascular surgery is still a new exploratory field and only a small percentage of patients are eligible for this technique. Therefore, the only option for most patients is to undergo traditional surgical repair, according to Dr. Vorp. The decision to repair an aneurysm is usually based on its maximum diameter, he said. Some AAAs may have the same maximum diameter, but may have differences in shape, wall thickness, or mechanical properties which have an effect on their growth and potential to rupture. From an engineering perspective, the proper definition of 'critical state' for an AAA is when its capacity to withstand forces is about to be breached, Dr. Vorp said.