Aneurysm surgery treats a localized bulge in an artery wall, either in the aorta, the body's largest artery, or in peripheral arteries such as the femoral artery or the one behind the knee. A stretched wall weakens over time and may rupture, so the aim is to reduce the risk of rupture and protect blood flow. A ruptured aneurysm is an emergency requiring immediate hospital care.
Repair may be open surgery, replacing the bulging segment with an artificial graft, or endovascular repair, placing a covered stent inside the artery through a small groin incision. Open surgery uses general anesthesia; some endovascular repairs may need only local or spinal anesthesia. The team chooses the method according to the location and size of the aneurysm and the patient's health.
The operation usually takes two to six hours. Open aortic surgery often means a hospital stay of a week or more, while endovascular repair usually needs less. Recovery is usually complete within weeks to a few months, with regular imaging follow-up.
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It lowers the risk of the artery rupturing, which is among the most dangerous emergencies, and keeps blood flowing to the organs or limb. It may also relieve symptoms such as pain, numbness or a cold foot when clots have formed in a peripheral aneurysm.
The doctor decides based on the aneurysm's size, location, growth rate and symptoms, and on heart, lung and kidney health. A small aneurysm may only need regular monitoring, while a large, fast-growing or symptomatic one often calls for treatment.
Preparation includes blood tests, vascular imaging and a heart and lung assessment. Tell the doctor about all your medicines, especially blood thinners, and never stop or change them unless instructed. Quitting smoking is advised, and fasting is required before surgery.
In open surgery, the surgeon reaches the aneurysm, temporarily stops blood flow through the artery and sews in an artificial graft. In endovascular repair, a covered stent is guided through the femoral artery and expanded inside the aneurysm to shield it from blood pressure. For peripheral aneurysms, a graft or bypass may be used.
Open surgery usually involves several days in hospital, sometimes starting in intensive care, then weeks of rest and avoiding heavy lifting. Recovery after endovascular repair is usually faster. The care team sets the imaging follow-up schedule.
The risk of rupture usually falls once the repair succeeds, and activity improves gradually over weeks to months. Durability depends on the type of repair and the condition of the arteries. Regular follow-up stays essential because the underlying disease does not disappear with surgery.
They may include bleeding, infection, heart, lung or kidney problems, graft blockage or clots, and leakage around the stent after endovascular repair. Some complications may need a further procedure. Rarely, blood supply to the spinal cord or organs is affected. Risks are higher in emergency surgery after rupture.
Open surgery leaves a scar on the abdomen, chest, groin or behind the knee depending on the aneurysm's site. Endovascular repair usually leaves two or three small scars in the groins.
It varies with the type of repair: often one to two weeks after endovascular repair and two to four weeks after open surgery. Your treating doctor confirms the right time after an examination.
Sudden severe pain in the abdomen, back or chest, dizziness, fainting, pallor and sweating, or sudden cold pain in a leg. This is an emergency, so call an ambulance immediately without waiting.
