Article - Closure of abdominal aneurysms

Closure of abdominal artery aneurysms

An aneurysm is an abnormal dilation of a blood vessel wall, formed due to tissue weakening and resembling a small balloon filled with blood. When this expansion occurs in the abdominal arteries, such as the aorta or the arteries supplying blood to internal organs like the liver or spleen, there is a significant danger of sudden rupture. Such a rupture could lead to massive and life-threatening internal bleeding within a very short time.

he goal of the aneurysm closure procedure is to prevent further growth of the aneurysm and eliminate the risk of its explosion by blocking blood flow into the weakened area and reinforcing the arterial wall. The procedure is performed using an advanced catheterization approach, without the need for extensive surgical opening of the abdomen or leaving large scars.

Before starting the treatment, the patient undergoes a series of preliminary imaging tests, such as CT or MRI, which allow the physician to plan the precise path within the blood vessels. During the procedure, the interventional radiologist inserts a thin and flexible catheter through the femoral artery or the arm artery, under precise real-time X-ray imaging guidance. The catheter is carefully navigated through the arterial system until it reaches the exact location of the aneurysm. At this stage, dedicated devices are implanted within the aneurysm to block it. In most cases, delicate metallic coils made of platinum are used to fill the aneurysm cavity and cause the formation of a stable blood clot within it, or a flexible stent-graft covered with special synthetic fabric is used to create a new internal conduit for blood flow, isolating the aneurysm from arterial pressure.

This treatment is particularly suitable for patients with aneurysms that have grown beyond a certain diameter, patients with symptoms of pain, or individuals whose general medical condition makes open surgery too risky. At the end of the procedure, the catheter is removed from the body, and a vascular closure device is placed at the puncture site to enable rapid healing without the need for external stitches.

Among the advantages are

The minimally invasive approach through a tiny skin puncture instead of a large and painful surgical incision.
Recovery time is exceptionally short, and most patients are discharged to their homes within only one day.
Risk of significant blood loss or post-operative infections is considerably lower compared to open surgeries.
Can be performed under local anesthesia or deep sedation, which avoids the risks of general anesthesia.
Allows maximum precision in placing the blocking devices while preserving the integrity of adjacent blood vessels.
Patients report less pain and discomfort after the procedure, enabling an immediate return to full functioning.

Disadvantages and risks

Risk of a blood leak into the aneurysm after the procedure, which sometimes requires supplemental treatment.
Need for medical follow-up, including periodic imaging tests, to ensure the long-term stability of the repair.
An allergic reaction or impairment of kidney function may develop as a result of the use of contrast dye.
Possibility of local damage to the blood vessels, such as hematoma formation or damage to the arterial wall.
In rare cases, the blocking devices may migrate from their position or affect blood flow to nearby internal organs.
In some instances, the patient's anatomical structure leads to the need for a change in the treatment plan.