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Types of Aortic Aneurysm Grafts

An aortic aneurysm is the ballooning of a weakened section of the main artery of the body, the aorta. Because of the risk of life-threatening bleeding from the rupturing of the vessel, an aortic aneurysm is considered a serious condition and is monitored closely. Aneurysms that grow large enough to be at risk of rupturing are repaired through open surgery (via the abdomen) or minimally invasive endovascular surgery (via catheter). Materials used in grafts can vary, and the type of graft employed is contingent upon which surgery is chosen.

  1. Types

    • An aneurysm can occur anywhere along the aorta, which runs the length of the body, but it appears in 75 percent of cases at the level of the abdomen. This is called an abdominal aortic aneurysm (AAA), according to MayoClinic.com. An aneurysm that develops at the level of the chest wall is of the thoracic type.

    Risk Factors

    • Men ages 60 and older are the target group for this condition. Although women can develop aneurysms, men are five to 10 times more likely to be diagnosed, says MayoClinic.com. Most significant risk factors are being Caucasian, smoking, and having high blood pressure, atherosclerosis (plaque buildup in arteries) and a family history of the condition.

    Open Surgery Grafts

    • The standard approach to AAA repair is open surgery, in which an incision is made along the length of the torso from below the breastbone to just below the navel. This allows direct access to the aorta. Once the abdomen is opened, a cylinder-shaped graft is sewn into the aneurysm sac itself, connecting the two ends of the aorta. The aneurysm wall is then sewn around the graft.

      Grafts used in aneurysm repair are made of various materials. One commonly used type for open surgery is made from the polyester fabric Dacron, either gelatin-coated double-velour or collage-coated double-velour. Another is made from a nonfabric synthetic material called polytetrafluoroethylene (PTFE), according to Stanford Hospital & Clinics.

    Closed Grafts

    • Endovascular aneurysm repair (EVAR) is a minimally invasive approach that allows for faster recovery and involves fewer surgical risks than open surgery. A stent-graft is inserted through an artery near the groin, and from there it is advanced to the site of the aneurysm. Once there, it is spring-loaded into place. The stent-graft is a long and thin metal cylinder with a Dacron or PTFE graft attached. The stent serves to hold the graft in place.

    Graft Comparison

    • In a study reported in the journal European Surgery, three different kinds of aneurysm grafts were examined for wear and tendency to stretch, or dilate. One hundred sixty-four AAA surgery patients and their grafts were followed for 6.5 years. The gelatin-coated double-velour Dacron (GEL-D), collage-coated double-velour Dacron (COL-D) and stretch PTFE bifurcation grafts all performed equally well over the study period. However, the PTFE graft exhibited considerably less dilation.

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