Treatment of an aortic aneurysm

The size of an aneurysm that needs to be treated depends on the part of the body affected. Treatment should be carried out in the aorta from a diameter of 5.5 cm. If the aneurysm has not yet reached this size, it should be checked once a year to see whether it is growing.


There are basically two ways to treat an aortic aneurysm: The so-called endovascular therapy with catheter technology and the classic open operation. The choice of treatment depends on the form and the affected area as well as your state of health. We will give you specific advice on all factors and, if necessary, arrange for further examinations.

In order to find the best possible solution and therapy for you, your case will be discussed in our vascular conference with various experts. Thanks to the proven expertise of our staff in the field of major artery disease, we can offer you both endovascular therapy and open surgery as very safe methods. In order to provide you with optimal care before, during and after the procedure, we also have a cardiologist and angiologist on our team who specializes in diseases of the aorta.

Endovascular therapy (stent prosthesis)

Endovascular therapy is the treatment of the aneurysm with a stent prosthesis. In the aorta, this procedure is called EVAR (EndoVascular Aortic Repair). Using the catheter technique, the stent prosthesis is inserted via the inguinal artery and placed in the area of the aneurysm. Stent prostheses consist of a wire frame in the form of a tube with a sheath made of special material. If vessels for the internal organs branch off from the aneurysm, stent prostheses with corresponding cut-outs are inserted. Placement is carried out under X-ray control to ensure precise positioning.

Compared to open surgery, endovascular therapy can often be performed under local anesthesia and without anesthesia. Only small incisions are usually required in both groins to insert the stent prosthesis. Due to the small surgical wounds, you can usually leave the hospital after just four days. Regular follow-up checks are required according to EVAR in order to ensure the success of the therapy over a long period of time. The correct position of the stent prosthesis, a secure seal and the size of the aneurysm are checked.

A minor disadvantage of the endovascular procedure is that catheter-based corrective interventions are required in around one in ten patients. Over the course of time, changes in the aortic wall, e.g. the stent prosthesis or individual parts may slip. This can result in renewed blood flow to the aneurysm with a renewed risk of bursting.

Open surgical therapy

Open surgery is the classic method that has proven itself over many years. During aneurysm surgery, the aneurysm is removed via an abdominal or flank incision and replaced with an artificial vessel. This is sewn in by hand with great care. To prevent major blood loss, the main artery must be clamped for a certain period of the operation. The healing process after open surgery is longer than after EVAR due to the larger wound area and is usually more physically demanding. The inpatient stay usually lasts ten days.

The great advantage of open surgery is its long durability. Corrective interventions are very rarely necessary. The fact that the aneurysm was largely removed means that there is no risk of renewed blood flow through the aneurysm. Nevertheless, regular follow-up checks should also be carried out after open surgery. The focus here is on the seams.

After the procedure

The recovery phase after EVAR takes about two to three weeks, after open surgery about six to eight weeks. Following the inpatient stay after open surgery, we recommend a stay of approximately two to three weeks in a rehabilitation facility to regain physical resilience. This is usually not necessary according to EVAR.

After both interventions, walking and gait training is the best therapy to regain performance. You should also pay attention to a healthy lifestyle for a good recovery and with regard to your future life. This includes regular physical activity, weight reduction, good blood pressure control, consistent use of prescribed medication and, above all, abstaining from nicotine.

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University Hospital Zurich
Department of Vascular Surgery
Rämistrasse 100
8091 Zurich

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