Counties Manukau Health Vascular Surgery Service
The aorta, which is the main artery of the body can change over time (aneurysm) to the point where it can rupture. This is usually a fatal event. This process often occurs to the part of the aorta inside the abdomen below where the kidney arteries have branched off and an aneurysm of this part of the aorta is called an Abdominal Aortic Aneurysm (AAA).
Patients who have an incidental finding of an aortic aneurysm should be referred to a vascular surgeon, from there depending on size the patient will be kept under surveillance with a scan at regular intervals. The risk of rupture depends on the diameter of the aorta and once the threshold is reached (about 5cm) elective repair is usually offered.
There are now 2 main methods of repair of an AAA:
The first is what is called 'open repair' whereby an incision is made in the abdomen and the aneurysmal aorta is replaced by a prosthetic graft.
Endovascular Aortic Repair
The second technique is called Endovascular Aortic Repair (EVAR). In this procedure access to the arteries is gained via the main groin artery (common femoral artery) and with the guidance of a radiology machine, a specially packaged graft is passed up over a wire and deployed inside the aorta to act as a new pathway for the blood to flow through. The aneurysm is depressurised and won’t rupture. Long term follow up with radiological imaging is required if this technique is used. At Middlemore Hospital this is a combined procedure performed with the Interventional Radiologists.