Endovascular abdominal aortic aneurysm repair is surgery to fix a widened part (or aneurysm) in your aorta, the large artery that carries blood to your belly, pelvis, and legs.
An aortic aneurysm is when a part of this artery becomes too large, or balloons outward, due to weakness in the wall of the artery.
Unlike standard surgery, in which a surgical cut is made in the abdomen, endovascular aortic repair is done without any major surgical cut.
EVAR; Endovascular aneurysm repair - aorta; AAA repair - endovascular; Repair - aortic aneurysm - endovascular
You will lie on a padded table in an operating room, in the radiology department of the hospital, or in a catheterization lab. You may receive general anesthesia (you are asleep and pain-free) or epidural or spinal anesthesia.
Endovascular aortic repair is done because your aneurysm is very large, growing quickly, or is leaking or bleeding.
You may have an abdominal aortic aneurysm that is not causing any symptoms or problems. Your doctor may have found out about this problem from tests called an ultrasound or CT scan. There is a risk that this aneurysm may open up (rupture) if you do not have surgery to repair it. However, surgery to repair the aneurysm may also be risky. In such cases, endovascular repair is an option.
You and your doctor must decide whether the risk of having this surgery is smaller than the risk of rupture if you do not have surgery to repair the problem. The doctor is more likely to recommend that you have surgery if the aneurysm is:
Endovascular repair has a lower risk of complications compared to open surgery. Your doctor is more likely to suggest this type of repair if you have other, more serious medical problems or you are elderly.
Risks for any surgery are:
Risks for this surgery are:
Your doctor will do a thorough physical exam and tests before you have surgery.
Always tell your doctor or nurse what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription.
If you are a smoker, you should stop. Your doctor or nurse can help.
Do NOT drink anything after midnight, the day before your surgery, including water.
On the day of your surgery:
Most people stay in the hospital for 3 to 5 days after this surgery, depending on the type of procedure they had. Compared to open surgery, you should recover more quickly, have less pain, and go home sooner.
During a hospital stay, you may:
Recovery after endovascular repair is usually fairly quick.
You will need to be watched carefully over time for signs or symptoms that your repaired aortic aneurysm is leaking blood.
Gloviczki P, Ricotta JJ II. Aneurysmal vascular disease. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 65.
De Bruin JL, Baas AF, Buth J, Prinssen M, Verhoeven EL, Cuypers PW, et al: DREAM Study Group. Long-term outcome of open or endovascular repair of abdominal aortic aneurysm. N Engl J Med. 2010;362:1881-1889.
United Kingdom EVAR Trial Investigators, Greenhalgh RM, Brown LC, Powell JT, Thompson SG, Epstein D, Sculpher MJ. Endovascular versus open repair of abdominal aortic aneurysm. N Engl J Med. 2010;362:1863-1871.