An aneurysm is a swelling or dilation of a weakened wall in an artery. Arterial aneurysms have a tendency to grow and burst causing life-threatening bleeding. Traditionally, aortic aneurysms have been treated with open surgical repair of the dilated artery. Using an abdominal incision, open surgical repair of abdominal aortic aneurysms allows for the complete removal of the aneurysm with a replacement that involves the use of a piece of Teflon tubing.

Within the last five years a new approach to treating aortic aneurysms has been developed. It is a minimally-invasive approach using endoscopy. Tiny incisions in the groin are made using advanced x-ray and catheter technology. Patients who have undergone this new mode of treatment spend much less time in the hospital and return to their normal activities much earlier.

Aneurysms develop slowly over many years and often have no symptoms. If an aneurysm becomes too large, expands rapidly, tears open (ruptured aneurysm), or leaks blood along the wall of the vessel (aortic dissection), repair is usually required. Aortic aneurysm rupture is life-threatening and requires immediate surgical repair. Only open repair can be done in such instances.

The symptoms of rupture include:

• Pulsating sensation in the abdomen
• Pain in the abdomen or back - severe, sudden, persistent, or constant. The pain may radiate to the groin, buttocks, or legs.
• Abdominal rigidity
• Anxiety
• Nausea and vomiting
• Clammy skin
• Rapid heart rate when rising to a standing position
• Shock
• Abdominal mass

An abdominal aortic aneurysm can develop in anyone, but it is most frequently seen in males over 60 with one or more risk factors. The larger the aneurysm, the more likely it is to rupture.

Aortic aneurysms are now the 10th leading cause of death among American men and the 13th leading cause of death in women. It is unclear why aneurysms are becoming more common and what causes them, although diet and genetics are likely contributing factors.

If the aneurysm is small and there are no symptoms (for example, if it was discovered during a routine physical), your doctor may recommend periodic evaluation. This usually includes a yearly ultrasound, to see if the aneurysm is getting bigger.

Your physician might prescribe:

• Antihypertensive drugs to treat high blood pressure. Medications called beta blockers can help decrease the force on the arterial wall. As a result, they may be able to slow the rate at which the aortic aneurysm expands.
• Cholesterol-reducing drugs to lower cholesterol levels.

Quitting smoking is also an important part of therapy.

Prior to any surgery, your doctor will give you a complete medical examination and evaluate your overall health and your health history. You may be required to get additional tests such as X-rays and lab tests. Your doctor will also review with you the potential risks and benefits of the operation and will ask you to sign a consent form. It is important that you ask questions and be sure you understand the reason for the surgery as well as the risks.

It is important that you inform your doctor if you have allergies to any medications, what medications you are taking, and if you have bleeding problems. It is also important to inform your doctor if you are pregnant.

Your doctor will also give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, taking or avoiding certain vitamins and medications. Carefully following these instructions will help your surgery go more smoothly.

Depending on the circumstances of your surgery, you may be instructed to do the following:

• Completely empty your colon and cleanse your intestines prior to surgery. You may be requested to drink clear liquids only for one or several days prior to surgery.
• Stop eating or drinking after midnight the night before the operation except medications that your doctor has told you are permissible to take with a sip of water the morning of surgery.
• Plan for your care and recovery after the operation. Find someone to drive you home after the surgery. Allow for time to rest and try to find people to help you with your day-to-day duties.
• Stop smoking at least six to eight weeks prior to surgery as smoking delays wound healing. Smokers are also more likely to have breathing problems during surgery.

Immediately following your surgery, you will be transferred to the Intensive Care Unit (ICU) where you will be closely monitored. You will remain asleep from the anesthesia for a few hours after the surgery.

Most patients after elective endovascular aortic aneurysm repair are able to go home approximately four or five days after the surgery. Expect to return to your normal level of activity within three to six weeks. You should begin walking short distances every day while gradually increasing the distance. Walking is the best exercise for you.

A variety of factors may influence the cost of the surgery. They include:

• Insurance coverage
• Pre-existing health
• Insurance co-pay
• Location of the facility

These factors vary depending on you and your situation.

The cost of each procedure can vary dramatically based upon age, location, gender, and insurance coverage. HealthGrades provides detailed cost estimates which include the costs of the procedure, drugs, hospital stay, and more. Each cost estimate is easy to understand and provides medical terms you need to know.

The detailed cost estimate for Aortic Aneurysm Repair, includes costs for:

• Endovascular abdominal aneurysm repair
• Open surgery for ascending aorta graft or stent while on bypass machine
• Ascending aorta graft
• Transverse aortic arch graft
• Descending thoracic aorta graft
• Open surgery to repair aortic aneurysm with graft
• Endovascular repair using aorto-aortic tube prosthesis (either small, modular, unibody, aorto-iliac, or aorto-unifemoral prosthesis)
• and Open repair following an unsuccessful endovascular repair attempt using aorto-aortic tube prosthesis (either small, modular, unibody, aorto-iliac, or aorto-unifemoral prosthesis).