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Stent-graft placement in abdominal aortic aneurysm

Guidance issued Guidance issued
 
IP Guidance Number: IPG163
 
Summary:

NICE issued full guidance on this procedure to the NHS in England and Wales in September 2003. It included a statement saying that the procedure would be reconsidered pending the results of the EndoVascular Aneurysm Repair (EVAR) trials and an updated systematic review to be commissioned by NICE.

The National Institute for Health and Clinical Excellence (NICE) has issued updated guidance to the NHS in England, Wales, Scotland and Northern Ireland on stent-graft placement in abdominal aortic aneurysms. The Interventional Procedures Advisory Committee reconsidered the procedure based on the results of a systematic review commissioned by NICE.

It replaces previous guidance on stent-graft placement in abdominal aortic aneurysm (Interventional Procedures Guidance no 10).
Description:

This procedure is used to treat aneurysms of the abdominal aorta. 

Weakening of the wall of the aorta can lead to a dilatation of the vessel, or aneurysm. Aneurysms may rupture, causing internal bleeding.

Around 6000 operations on the aorta are carried out each year in England (Source: Hospital Episode Statistics, Department of Health, ungrossed for missing data, 2000/1), most of which are for abdominal aortic aneurysms.

Smaller aneurysms and aneurysms in people considered unfit for surgery may be managed with medical treatment alone. The standard invasive treatment for abdominal aortic aneurysm is open surgical repair. The aneurysm is cut open and a graft is sewn in above and below the weakened area to allow normal blood flow.

Stent-graft placement is a minimally invasive alternative to open surgery. In this technique, the graft is mounted on a stent, which is inserted into the aorta via a catheter in the femoral artery. The stent is opened under X-ray guidance, wedging the graft across the aneurysm.

Arrangements:

Other (see guidance)
Topic Area:

Cardiovascular
Surgical procedures
Specialty:

Cardio-thoracic surgery
Clinical radiology
Specialist advice has
been sought from:

Vascular Surgical Society of Great Britain and Ireland

British Society of Interventional Radiology
Date notified to NICE: 01 April 2002
Provisional Consultation Date: December 2005
Guidance Publication Date: 22 March 2006
Contact Details:
Contact Address:

Interventional Procedures Programme
National Institute for Health and Clinical Excellence
MidCity Place
71 High Holborn
London
WC1V 6NA
Links:

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