Abdominal Aortic Aneurysm Repair: Endovascular (Emergency)
Steps Involved in IVF:
Procedure Description
Abdominal Aortic Aneurysm Repair through an endovascular approach (EVAR) is a minimally invasive procedure used to treat an abdominal aortic aneurysm (AAA). An AAA is a ballooning or dilation of the abdominal section of the aorta, the large blood vessel that supplies blood to the body. When the aneurysm reaches a certain size, it can pose a significant risk of rupture, which can lead to life-threatening bleeding. An endovascular approach is often utilized as an emergency measure to prevent or repair such a rupture, offering a less invasive alternative to open surgical repair.
The procedure involves the insertion of a stent-graft through the femoral artery (located in the groin). The stent-graft is a synthetic tube made of fabric supported by metal wire stents. It is carefully maneuvered through the arteries to the site of the aneurysm. Once in place, the stent-graft expands to fit the size and shape of the normal aorta, creating a new path for blood flow that bypasses the weakened aneurysm wall. This prevents blood from flowing into the aneurysm, reducing the risk of rupture.
Endovascular repair is considered advantageous over traditional open surgery as it avoids large incisions, reduces trauma to the body, and usually results in a quicker recovery. However, this procedure may not be suitable for all patients, particularly those with an irregular aneurysm shape or challenging arterial anatomy. When performed as an emergency intervention, the procedure focuses on immediate stabilization of the patient and prevention of fatal outcomes.
Procedure Duration
The duration of an endovascular abdominal aortic aneurysm repair (EVAR) varies depending on the complexity of the aneurysm and the patient's anatomy. Typically, the procedure can take anywhere from 1 to 3 hours, considerably shorter than the open surgical repair, which may take up to 6 hours or more. For emergency EVAR, the time is of the essence, and the surgical team prioritizes rapid stabilization to prevent rupture or to address ongoing bleeding.
The procedure can be broken down into several phases:
- Preparation and Access Phase: The patient is given anesthesia, and small incisions are made near the groin to access the femoral arteries. A guide wire and catheter are inserted and navigated through the arterial system to the aneurysm.
- Deployment Phase: The stent-graft is placed within the catheter and guided to the site of the aneurysm. The surgeon deploys the stent-graft in the correct position to ensure proper blood flow through the new pathway while sealing off the aneurysm. Imaging techniques, such as fluoroscopy, are used to visualize the stent's positioning in real-time.
- Closure and Recovery Phase: Once the stent-graft is properly placed and blood flow is rerouted, the catheter and guide wires are withdrawn, and the incisions are closed. Patients are typically moved to a recovery room or intensive care unit for monitoring immediately after the procedure, especially in emergency scenarios.
Recovery from EVAR is typically quicker than from open surgery. Most patients can expect to stay in the hospital for 2-3 days post-procedure, with full recovery often occurring within 1-2 weeks. However, emergency cases might involve longer hospital stays, and regular follow-up imaging (usually via CT scans or ultrasounds) is required to monitor the success of the repair and check for complications like endoleaks.
Benefits
- Minimally Invasive: EVAR requires only small incisions in the groin area, reducing recovery time and minimizing scarring.
- Shorter Hospital Stay: Patients generally spend fewer days in the hospital compared to open repair surgery, allowing for faster return to normal activities.
- Reduced Blood Loss and Trauma: The minimally invasive nature of EVAR results in less blood loss during the procedure and less trauma to the body.
- Quick Relief from Aneurysm Risk: The stent-graft provides an immediate bypass for blood flow, reducing the risk of aneurysm rupture and the associated life-threatening complications.
- Suitability for High-Risk Patients: EVAR is often an option for patients who may not tolerate open surgery due to age or other health conditions.
Potential Destinations
- United States The U.S. offers state-of-the-art technology and highly experienced vascular surgeons, making it an ideal destination for high-quality EVAR procedures. The healthcare infrastructure is equipped to handle emergency situations efficiently.
- Germany Germany is known for its advanced medical care and comprehensive healthcare system. Many German hospitals are well-equipped to perform EVAR, offering rapid intervention for emergencies, along with high standards of post-operative care.
- India India provides affordable healthcare options while maintaining a high standard of care. Hospitals in major cities are equipped to perform EVAR with experienced vascular surgeons and state-of-the-art equipment, attracting patients seeking cost-effective yet reliable treatment.
- Turkey Turkey has developed into a medical tourism hub with its modern healthcare infrastructure and highly skilled professionals. Turkish hospitals have advanced imaging and endovascular equipment, ensuring efficient treatment for abdominal aortic aneurysms.
- Singapore Singapore boasts a world-class healthcare system with hospitals that provide comprehensive care for vascular conditions. Known for its high standards in medical care and expertise in minimally invasive procedures, Singapore is a top destination for EVAR.
Risks & Considerations
- Endoleaks: A potential complication where blood continues to flow into the aneurysm sac after EVAR, requiring monitoring and possible further treatment.
- Infection: As with any surgical procedure, there is a risk of infection at the site of incision or within the graft itself, which could require antibiotics or additional intervention.
- Stent Migration: The stent-graft may shift over time, which could result in complications or failure to exclude the aneurysm from blood flow effectively.
- Kidney Damage: The use of contrast dye in imaging during the procedure can potentially affect kidney function, particularly in patients with pre-existing kidney disease.
- Graft Blockage or Clotting: Blood clots can form within the stent-graft or nearby arteries, potentially causing blockages and necessitating further treatment.
How to Choose the Right Doctor and Hospital
When seeking EVAR, especially in an emergency, choosing the right doctor and hospital is crucial for successful treatment. Here are key considerations:
- Experience and Specialization: Select a vascular surgeon with extensive experience in endovascular procedures, particularly those who specialize in aneurysm repairs. Verify that the surgeon is board-certified and has performed a significant number of EVAR procedures.
- Hospital Facilities and Technology: Opt for a hospital that has up-to-date imaging equipment, advanced stent-grafts, and comprehensive post-operative care facilities. Emergency cases require a well-equipped facility capable of rapid intervention and continuous monitoring.
To receive a free quote for this procedure please click on the link: https://www.medicaltourism.com/get-a-quote
Patients are advised to seek hospitals that are accredited by Global Healthcare and only work with medical tourism facilitators who are certified by Global Healthcare Accreditation or who have undergone certification from the Certified Medical Travel Professionals (CMTP). This ensures that the highest standards in the industry are met. GHA accredits the top hospitals in the world. These are the best hospitals in the world for quality and providing the best patient experience. Click the link to check out hospitals accredited by the Global Healthcare Accreditation: https://www.globalhealthcareaccreditation.com
Frequently Asked Questions
What actually happens during hyperstimulation of the ovaries?
The patient will take injectable FSH (follicle stimulating hormone) for eight to eleven days, depending on how long the follicles take to mature. This hormone is produced naturally in a woman’s body causing one egg to develop per cycle. Taking the injectable FSH causes several follicles to develop at once, at approximately the same rate. The development is monitored with vaginal ultrasounds and following the patient’s levels of estradiol and progesterone. FSH brand names include Repronex, Follistim, Menopur, Gonal-F and Bravelle. The patient injects herself daily.
What happens during egg retrieval?
When the follicles have developed enough to be harvested, the patient attends an appointment where she is anesthetized and prepared for the procedure. Next, the doctor uses an ultrasound probe to guide a needle through the vaginal wall and into the follicle of the ovary. The thin needle draws the follicle fluid, which is then examined by an embryologist to find the eggs. The whole process takes about 20 minutes.
What happens to the eggs?
In the next step, the harvested eggs are then fertilized. If the sperm from the potential father, or in some cases, anonymous donor, has normal functionality, the eggs and sperm are placed together in a dish with a nutrient fluid, then incubated overnight to fertilize normally. If the sperm functionality is suboptimal, an embryologist uses Intracytoplasmic Sperm Injection to inject a single sperm into a single egg with an extremely precise glass needle. Once fertilization is complete, the embryos are assessed and prepared to be transferred to the patient’s uterus.
How are the embryos transferred back to the uterus?
The doctor and the patient will discuss the number of embryos to be transferred. The number of successfully fertilized eggs usually determines the number of eggs to be placed in the uterus. Embryos are transferred to the uterus with transabdominal ultrasound guidance. This process does not require anesthesia, but it can cause minor cervical or uterine discomfort. Following transfer, the patient is advised to take at least one days bed rest and two or three additional days of rest, then 10 to 12 days later, two pregnancy tests are scheduled to confirm success. Once two positive tests are completed, an obstetrical ultrasound is ordered to show the sac, fetal pole, yolk sac and fetal heart rate.
Embryoscope©
Built into this technology there is a microscope with a powerful camera that allows the uninterrupted monitoring of the embryo during its first hours of life. In this way, we can keep a close eye on the embryo, from the moment when the oocyte is inseminated and begins to divide into smaller and smaller cells, until it can be transferred to the uterus.
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Punta Mita Hospital - Genesis Cell
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