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The Aorta
The aorta is the largest artery in the body. It is also the most important blood vessel. If there is a problem with your aorta or arteries, the blood flow to the rest of your body is decreased. An aortic aneurysm is a weakened part of the artery. It looks like a bulge or balloon in the wall of the vessel. It can occur in the part of the aorta that is in the chest or in the abdomen. In the abdomen, it is called an abdominal aortic aneurysm (AAA). If the aneurysm bursts or tears, it can cause life-threatening bleeding.
Symptoms of Aneurysm
You may not have any symptoms, but these may be present:
Back or abdominal pain
Pulsating feeling in abdomen
Discolored feet
Endovascular AAA Surgery
During endovascular AAA surgery, we make two small incisions in the groin and insert a small catheter into the artery. We then insert a small stent-like device into the artery. Using a machine like an x-ray, we watch the image of the thin, tube-shaped device (graft) as it is threaded up the artery. Once it reaches the aneurysm, the device expands to provide a new wall for the artery.
What to Expect in the Hospital
You will have an IV until you can drink liquids.
You may have an IV in an artery to watch your blood pressure.
You may have a catheter to drain urine from your bladder.
The nurse will help you to get out of bed as soon as you are ready.
We will teach you how to use an incentive spirometer to prevent pneumonia.
Plan to go home the day after surgery.
Incision Care
Showers are okay.
Do not swim or take tub baths until approved by your doctor.
Clean the area gently with mild soap and water and remove any dried drainage.
Keep groin incisions dry.
Cover groin incisions with a bandage or dry gauze.
Do not use any lotions, alcohol, or powders until approved by your doctor.
Look at your wound daily for signs of infection.
Signs of Infection
Increased redness or warmth at the incision site
Red streaks that start at the stitches or staples
New drainage from your wound (drainage may be foul-smelling, cloudy, yellow, or green)
Bulging or increased swelling at the incision site
Fever over 101.5° F (38.5° C) by mouth, for two readings taken 4 hours apart
Sudden increase in pain at your wound that is not relieved by your pain medicine
Activity
Allow yourself time for rest as you will tire easily. You may feel weaker. This is normal. Your strength and energy level will increase as your body heals.
In the first few weeks after surgery:
Do not lift more than 5-10 pounds during the first 2 weeks at home.
Do not drive until your doctor says it is okay. Do not drive while taking opioid pain medicine.
Ask your doctor when you may return to work and resume sex.
Pain Control
You will have some pain after surgery. You can use over-the-counter pain medicine for pain as needed. Your doctor may have also prescribed opioid pain medicine for you to use at home. As you heal, the pain should improve and you should need less pain medicine. Talk to your doctor before starting any medicine as it may interfere with other medicines you are taking.
Opioid pain medicine can make you constipated. Use over-the-counter stool softeners as needed. Drink plenty of fluids and eat high fiber foods. Staying active also helps prevent constipation.
Diet
You may lose your appetite and even lose weight. You should still try to eat because a healthy diet helps your body heal.
You should also drink enough fluid to stay hydrated. Dehydration can make you feel more tired and weak. Drink at least 8 to 10 eight-ounce glasses of fluid each day.
Antibiotics
If you have an artificial graft, you will need antibiotics before dental cleanings or dental procedures for the first year after your surgery. Tell your dentist or doctor about your artificial graft so you can get antibiotics. This may prevent a graft infection.
Leg Swelling
As you become more active, your legs may become more swollen. If this happens, elevate your legs when sitting. Your doctor may want you to wear compression stockings or ace bandages when you go home. These help to reduce swelling and return blood to the heart. Apply them before walking. If you wear ace bandages, they should be wrapped snugly from toe to knee. Your nurse will show you how to wrap them. Remove them when you go to bed.
Smoking
Try to quit smoking. Smoking delays wound healing. It decreases blood flow, shrinks arteries, and can raise your blood pressure. If you would like help quitting, call the Quit Line at 1-800-784-8669.
Follow Up
A vascular surgery nurse practitioner will call you about two weeks after you go home. You will have a follow up visit and CT scan in the Vascular Surgery Clinic about four weeks after you go home.
When to Call
Signs of infection at the incision.
Open spots between the stitches where the skin is pulling apart.
Skin along the incision is getting darker or turning black.
Cold or discolored legs.
Numbness, tingling, or loss of movement in your legs or feet.
Sudden increase in pain that is not relieved by your pain medicine.
Sudden increase in tenderness or swelling in your leg.
Fever over 101.5° F (38.5° C) by mouth, for two readings taken 4 hours apart.
Who to Call
Vascular Surgery Clinic
Monday through Friday
8 am to 5 pm
(608) 263-8915
After hours and on weekends, call
(608) 263-6400. Ask for the vascular surgery doctor on call. Give your name and phone number with area code. The doctor will call you back.
The toll-free number is 1-800-323-8942.
