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Arteries in the arms or the legsArteries that provide blood to the brainArteries that provide blood to the intestinesA stent-graft " A stent-graft is a tube made of special material that is often reinforced with metal. Stent-grafts like these are used to repair a problem called an "aneurysm, " which is when the walls of a blood vessel become weak and start to bulge out (figure 2). Surgeons insert grafts that are folded. When they reach the aneurysm, they unfold the graft. The graft pushes up against the walls of the blood vessel and serves as a liner. Blood flows through the graft just as it would through the vessel itself. With the graft in place, the vessel is protected from the force of the blood pressure, and that keeps the blood vessel from bursting.A coil or other device " Surgeons sometimes place coils or other devices inside balloon-like aneurysms, especially small ones, like those found in the brain or spleen. These devices seal off the aneurysm and keep it from bursting. The same devices are also used to help stop bleeding from blood vessels that are injured.A wire that heats up " Surgeons sometimes use heat to seal off a diseased vein.An umbrella device " One type of umbrella device is called is called a "vena cava filter, " which is used to filter blood clots in the large vein in the belly that drains the legs. This filter keeps blood clots from going to the heart. Surgeons get umbrella devices into place while they are in the closed position. Then, when they get to the part of the blood vessel or heart where they want to use the device, they open it.
Why do endovascular surgery instead of regular surgery? " In general " not always " endovascular surgery makes recovery easier. Thats because:
- It usually involves a small wound where the catheter goes in, instead of a big wound where the body is opened up.
- The inside of the body does not need to be exposed as it would with regular surgery.
- The organs don't get moved around as much as they would with regular surgery.
Despite all of the differences with regular surgery, endovascular surgery is still surgery. People who have it do have some pain, often need stitches, and can develop infections or other problems because of the surgery.
Is the decision to have endovascular surgery up to the patient? " Yes and no. Many procedures can now be done through an endovascular approach and sometimes the patient will help make the decision. But it's not always up to the patient to choose what type of surgery to have. Whether a patient can have endovascular surgery will depend on:
- Why the patient needs surgery
- What other health problems the patient might have
- Whether there is a surgeon available nearby who has enough experience doing the type of procedure, and if not, whether the patient is willing to go elsewhere for treatment
Even when a patient starts out having endovascular surgery, there's no guarantee that the surgery will stay that way. Sometimes surgeons start out doing endovascular surgery and then realize that they need to switch to regular surgery. This doesn't mean the surgeon has done anything wrong; it's just something that could happen after a surgery gets started.
If you go in for endovascular surgery, be prepared to wake up and find out that you had regular surgery. This could happen for a few different reasons, such as:
- The surgeon found something unexpected when he or she got started
- The surgeon couldn't see well enough or properly treat the body part he or she was trying to operate on
- Bleeding occurred that could not be controlled
The important thing to remember is that if a surgeon switches to regular surgery, it is usually to protect the safety of the patient.
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Nov 04, 2014.
Topic 85999 Version 3.0
Release: 22.8 - C22.206
© 2014 UpToDate, Inc. All rights reserved.
figure 1
Endovascular surgery
For endovascular surgery, the surgeon inserts a tube called a catheter into a large blood vessel, usually in the arm or leg. Then the surgeon pushes the tube further and further into the blood vessel until it reaches the part of the body that needs surgery. In this case, the catheter has been placed in the heart. Within the tube are special tools that the surgeon can use to treat different medical problems.
Graphic 85875 Version 1.0
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Endovascular surgery
For endovascular surgery, the surgeon inserts a tube called a catheter into a large blood vessel, usually in the arm or leg. Then the surgeon pushes the tube further and further into the blood vessel until it reaches the part of the body that needs surgery. In this case, the catheter has been placed in the heart. Within the tube are special tools that the surgeon can use to treat different medical problems.
Graphic 85875 Version 1.0
View Original
figure 2
Abdominal aortic aneurysm repair
For open surgery repair, the doctor cuts open your belly and replaces the bulging part of the aorta with a tube called a "graft. " This tube is made from manmade materials. It is sewn into place. Blood can flow normally through it.
To repair the aorta with an endovascular stent graft, the doctor cuts into a blood vessel in your thigh (at the spot where your thigh meets the rest of your body) and inserts a folded graft. Then the doctor threads the graft up to the bulging part of the aorta and unfolds it. This type of graft is not sewn into place. Blood flows through the graft.
Graphic 57520 Version 7.0
View Originalfigure 2
Abdominal aortic aneurysm repair
For open surgery repair, the doctor cuts open your belly and replaces the bulging part of the aorta with a tube called a "graft. " This tube is made from manmade materials. It is sewn into place. Blood can flow normally through it.
To repair the aorta with an endovascular stent graft, the doctor cuts into a blood vessel in your thigh (at the spot where your thigh meets the rest of your body) and inserts a folded graft. Then the doctor threads the graft up to the bulging part of the aorta and unfolds it. This type of graft is not sewn into place. Blood flows through the graft.
Graphic 57520 Version 7.0
View Original
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