Aneurysm Repair Procedures

An aneurysm is a bulge in a blood vessel wall due to weakened tissue. Large aneurysms and those growing in major blood vessels, like the aorta, can rupture. However, aneurysm repair procedures at Virginia Mason Franciscan Health lower this risk. We deliver exceptional care that has earned some of our locations national recognition.

Aneurysms can form in any vessel in the body. However, aneurysm repair procedures are commonly used for the aorta because it’s the largest blood vessel. It starts in your heart and ends at your pelvis. There are two main types of aortic aneurysms: thoracic (above the chest) and abdominal (below the chest).

We replace the blood vessel segment containing the aneurysm with a human-made device. It’s a hollow tube (stent) with a special fabric coating (graft). 

When you come to an experienced program like ours, you have access to the full range of options, including: 

• Endovascular aneurysm repair (EVAR): This minimally invasive technique uses small incisions and tiny instruments to treat aneurysms in the abdominal section of the aorta.

• Fenestrated endovascular aneurysm repair (FEVAR): We use this minimally invasive procedure to repair aneurysms near where the aorta branches off to other organs like the kidneys. It uses a stent graft with openings (fenestrations) for nearby arteries.

• Thoracic endovascular aneurysm repair (TEVAR): This technique is like EVAR but treats aortic aneurysms in your chest. 

• Open aneurysm repair: You may need open aneurysm surgery with a larger incision if you are not eligible for a minimally invasive procedure.

• Hybrid procedures: This type of repair combines minimally invasive and open procedures.

You receive services from board-certified vascular surgeons with years of experience in endovascular and open aneurysm repair procedures. We are local leaders in aneurysm treatment and maintain excellent outcomes even for complex cases. Meet our team.

Highlights of our program include: 

• High-volume program: Year over year, we perform a high volume of aneurysm procedures, including EVAR, TEVAR, FEVAR and open surgery. This depth of experience leads to precise treatments and low complication rates. 

• National recognition: Some locations maintain a “high performing” designation from U.S. News & World Report for abdominal aortic aneurysm repair. This procedure treats aneurysms in the body’s largest blood vessel (aorta). Only hospitals that significantly exceed national standards earn this designation.

• Appropriate care: Repair is not always necessary, especially for smaller aneurysms. If a procedure is best, we consider whether an endovascular repair or aneurysm surgery is right for you. We explain the risks and benefits of our recommendations so you feel confident about your treatment.

• Coordination: We often use a team approach to treat thoracic aortic aneurysms near the heart. Before your procedure, cardiac and vascular surgeons work together to plan your treatment. We may need to take additional precautions, like operating together, to ensure safe aneurysm repair surgery. Explore our coordinated aortic disease care.

People with a ruptured or dissected aneurysm, which is a medical emergency, need one of these procedures.

You may also need a repair procedure if you are at risk of an aneurysm rupturing or dissecting. Risk factors include an aneurysm that meets one or more of these criteria:

• Is large (5 centimeters or more in a woman, 5.5 centimeters in a man)
• Growing quickly (more than 5 millimeters over 6 months)
• Causing symptoms, like pain in your chest, abdomen or back

We determine whether an open or minimally invasive procedure is right for you. Many people are eligible for EVAR, TEVAR, and FEVAR. If you aren’t a good candidate for endovascular repair, an open procedure may be best.

What happens during your procedure depends on a variety of factors: 

• Pain control: You may receive general anesthesia to put you to sleep or a local anesthetic to help you relax. Both methods temporarily block sensation.
• Surgical approach: Endovascular aneurysm repair uses tiny incisions a little larger than a needle poke. Open aneurysm surgery may require a longer incision. 
• Incision location: For open surgery, the incision is typically made near the aneurysm site. If we use an endovascular approach, the incision or puncture will be made in your groin.
• Stent graft type: We use standard stent-grafts for most aneurysm repair procedures. Surgeons use a fenestrated device if the treatment area is near where a blood vessel branches off.

Aneurysms typically do not come back after a successful repair. However, it’s possible to experience complications like blood clots. They can occur shortly after your procedure or years later. Annual checkups with ultrasound scans help manage this risk. After undergoing a scan, you may be eligible to review the findings with our vascular specialists via virtual visit.

Learn more about testing and treatment in the Puget Sound.