An aneurysm is caused by the weakening of blood vessel walls. It can develop along any length of the artery, but the most common location is in the abdomen, below the renal arteries. The process that damages the blood vessel walls is called atherosclerosis. There are various risk factors for the development of an aneurysm, including diabetes, smoking, high blood pressure, and high levels of cholesterol in the blood. When a rupture of the aneurysm occurs in the abdomen or chest area, there is rapid blood loss, cutting off blood supply to vital organs, posing a real-life threat.
In most cases, an aneurysm does not present any symptoms until it grows to a size that begins to exert pressure on neighboring organs and nerves, or until it ruptures. An ultrasound or CT scan can detect an enlargement of the blood vessel, and if an expansion is identified, a follow-up plan is determined. As the aneurysm becomes larger, the risk of rupture or tear increases, similar to what happens when a balloon is inflated beyond its limit. A small aneurysm may only require periodic monitoring, but once it reaches a diameter of 5.5 centimeters, it necessitates treatment.
There are two accepted treatment methods: one is open abdominal surgery and replacement of the enlarged section of the artery, while the other is a minimally invasive procedure called endovascular stent grafting. Shaare Zedek Medical Center is the first in the country to offer a new innovative treatment for aortic aneurysm using a dual stent graft system that is inserted in parallel. The space between the stents is filled with a special polymer that secures the stents in place, preventing movement and blood leakage from side branches. This stent graft is suitable for a wide range of patients, ensuring stability over the years and reducing the need for repeated interventions.
In addition to the innovative stent graft, Shaare Zedek also installs the standard stent graft, consisting of several parts inserted through a catheter. The stent graft reduces the pressure on the aortic aneurysm, assists it in contracting, and prevents potential rupture. However, due to anatomical criteria, it is only suitable for about 70% of patients and may move from its original position and require repair in some cases. There are also cases where two blood vessels supply blood to the aneurysm sac, leading to renewed swelling of the aortic wall. About 20% of patients will require further intervention.