An endoluminal graft (ELG), also referred to as a stent, is an innovative development in treating abdominal aortic aneurysms and other arterial disease. Click on the video clip to see how a graft is implanted to repair an abdominal aneurysm.

What is an Aneurysm?
An aneurysm is a ballooning in the arterial wall. Aneurysms can form in the arteries throughout the body, but the most common location is in the abdomen in the major artery (aorta) just below the kidney (renal) arteries, which supply blood to the kidneys.



What causes an abdominal aortic aneurysm?
Atherosclerosis is the most common cause of abdominal aneurysms.  However, men are ten times more likely to develop an abdominal aneurysm.  Family history, abnormal levels of certain enzymes or infection of the vascular wall, and congenital defects can also lead to aneurysm formation.

What dangers do aneurysms present?
The danger from an aneurysm is that it will continue to bulge and may burst. When an aneurysm in a large blood vessel bursts, a person could bleed to death.

How are aneurysms diagnosed?
In addition to a complete medical history and physical examination, diagnostic procedures for an aneurysm may include any, or a combination of, the following:

• computed tomography scan (also called a CT or CAT scan) - a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays. A CT scan can show the diameter of the thoracic aorta and reveal aneurysms.
• magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.

For more information on each of these, as well as other diagnostic and surgical tests, refer to St. John’s Mercy Medical Center website.


What is an Endoluminal Graft (ELG)?
An ELG, also referred to as a stent, is an implantable tube composed of a combination of synthetic material and metal. It is inserted through an artery in the groin and is positioned inside the abdominal aorta at the site of the aneurysm. X-ray and ultrasound technologies projected on to a television monitor are used to create a map for the physician to locate the aneurysm.

How is the ELG procedure done?
The stent is inserted into the femoral artery by way of a small incision in the groin. It is then snaked up to the location of the abdominal aneurysm. Once in place, the stent is opened up, and it hugs tightly to the wall of the aorta.  After that, a balloon is inserted into the groin. It is guided up to the stent, and it is inflated to further secure the stent against the artery walls. 

Below are radiologic pictures of the aneurysm before and after the procedure. As you can see, the aneurysm completely shrunk after treatment with a stent.

Before:	After:
Untreated Aneurysm	Treated Aneurysm

If a stent is not used to treat an abdominal aortic aneurysm, what is the alternative?
If not treated with a stent, an abdominal aortic aneurysm is repaired through open surgery. The surgeon must make an incision in the abdomen and replace the diseased portion of the aorta with a synthetic graft, or tube. The graft is sewn into place with sutures. This procedure is performed while the patient is under general anesthesia.

What is the comparison of results & recovery: open surgical repair vs. stenting?
Results from open surgical repairs and stenting are very comparable. Both procedures have proven to be safe and effective, and current studies have shown outcomes for each to be rather similar. It is possible, however, that patients undergoing the open surgical procedure may have a longer recovery period due to the more invasive nature of the procedure.

Current Clinical Trials
For information about any of the clinical trials that the surgeons are involved in, please contact the St. Louis Vascular Center at St. John’s Mercy at 314-251-4200.