Aortic Aneurysm Treatment

The aorta is the body’s main artery, so an aortic aneurysm refers to a dilation of this central vessel. Aneurysms can form in any part of the aorta, though the most common site is the abdominal section, just below the renal arteries. A small aortic aneurysm requires regular monitoring, while surgical intervention is typically recommended when the diameter reaches 5 cm.

Aortic aneurysms are diagnosed in more than 3% of people over the age of 60 and are the cause of death in approximately 1 in 250 individuals over 50. The first sign of an aneurysm is often its rupture, which can be fatal. Because the condition is usually asymptomatic, it can go undetected for years.

Those at increased risk include smokers, individuals with hypertension, cardiovascular disease, or a family history of aortic aneurysm. Statistically, men are more frequently affected than women.

As aortic aneurysms do not cause discomfort and there are no general screening programs, they are often discovered incidentally during imaging tests — such as ultrasound or CT scans — ordered for unrelated reasons. For patients over 65, preventive ultrasound screening is considered advisable.

Symptoms of a ruptured aneurysm include sudden abdominal or back pain and fainting caused by a sharp drop in blood pressure.

A standard treatment for an aortic aneurysm is open surgical repair, in which the affected aortic segment is replaced with a synthetic graft. This surgical method has been in use since the 1960s and has proven highly effective in preventing rupture, often providing a solution that lasts for decades.

Expected Outcomes

In the overwhelming majority of cases, this procedure provides long-term correction of the aneurysm.

Procedure Overview

The surgery is performed under general anesthesia. A large abdominal incision is made to expose the aneurysm. After preparation, the affected portion is replaced with a synthetic implant. The incision is then closed with sutures and dressed.

Duration

The procedure takes several hours, depending on its complexity.

Risks and Success Rates

As with any invasive surgery, aortic aneurysm repair carries potential complications, including bleeding, infection, nerve injury, and damage to adjacent organs such as the intestines. There is also a risk of impaired blood flow to the kidneys, spinal cord, or lower limbs due to aortic clamping.

The mortality rate ranges from 4% to 8%. Complications may also involve the lungs, liver, or kidneys. Nonetheless, in most cases, the goal of aortic aneurysm treatment in Israel — preventing rupture — is successfully achieved.

Preoperative Preparation

Diagnosis is usually established via imaging such as abdominal ultrasound, CT, or MRI. Preoperative assessments include blood tests, ECG, and a chest X-ray. Patients on medications should consult their physician, especially if taking antihypertensives, antiplatelet, or anticoagulant drugs.

Postoperative Expectations

Initially, patients remain in intensive care for stabilization before being transferred to a general ward. Hospital stays typically last from one to two weeks depending on recovery progress. Full recovery and return to normal life usually take up to three months. After discharge, any temperature above 38°C or alarming symptoms should be reported immediately.

A less invasive aortic aneurysm treatment method now offered in Israel is endovascular stent-grafting, which avoids large incisions. Instead, the graft is inserted via a catheter through the femoral arteries, under fluoroscopic guidance. Once deployed, the stent-graft allows blood to flow through the reinforced segment, reducing pressure on the aneurysm walls and preventing rupture.

Benefits

This approach is suitable for more than half of patients diagnosed with an abdominal aortic aneurysm and offers faster recovery, lower complication rates, and shorter hospital stays compared to open surgery.

Procedure Details

EVAR is typically performed under general, regional, or local anesthesia. A contrast dye is used to guide the placement of the stent via imaging. The vascular surgery team in Israel ensures accurate placement and sealing above and below the aneurysm. The procedure lasts several hours.

Success Rate and Risks

The success rate exceeds 90%, with a mortality rate of just 1.2%, significantly lower than that of open surgery. Possible risks include bleeding at the catheter site, renal dysfunction, or delayed endoleak (blood leakage around the stent), which may require follow-up interventions. Lifelong imaging follow-up is required to monitor the stent’s position and function.

Hospital Stay and Recovery

Post-op, the patient remains under observation and is usually discharged within a few days. Physical exertion should be avoided in the early recovery phase. Gradual return to normal activity is expected over several weeks. Regular follow-up imaging is essential.