I saw this gentleman today in my clinic. I have been through his CT scan with him and his wife and I have explained to him about the pathology (the infrarenal abdominal aortic aneurysm). We had quite a long discussion about treatment options including no intervention. EVAR and open surgery. In view that he had a major laparotomy in the past following a ruptured colon with a colostomy and reversal of the colostomy, his abdomen is quite hostile which puts an open repair at a higher risk of complications. He is fully aware that with the EVAR repair there is less mortality risk as well as a significantly lower hospital stay, but continuous follow-up in the future will be required.
After a long discussion. Lord Avebury has decided to go for the EVAR repair which we are planning to do on 19th July. I have discussed his case with Dr W who will be ordering his stent. We have also agreed that he is not going to need any renal artery angioplasty prior to the procedure.