Smiling elderly man in hospital bed with supportive wife beside him, moments before EVAR surgery

EVAR may be the solution you need for an abdominal aortic aneurysm

Endovascular aneurysm repair (EVAR) is one of two procedures commonly used to treat abdominal aortic aneurysms (AAAs). EVAR is minimally invasive compared to open heart surgery and allows your vascular surgeon to operate through small incisions and redirect blood away from the abdominal aortic aneurysm, restoring blood flow through your aorta and to the rest of your body.

Vascular surgeons and medical staff performing Endovascular Aneurysm Repair (EVAR) in an operating room

Advanced repair for AAAs

An abdominal aortic aneurysm occurs when the wall of your aorta develops a bulge or aneurysm.

The aorta is your body’s largest artery, carrying blood to the abdomen, pelvis and legs. AAAs develop in the abdominal aorta, the portion of the aorta that passes through your belly. Aortic aneurysms disrupt the natural flow of blood to the abdomen, and EVAR prevents serious and even life-threatening consequences.

A similar procedure to EVAR, called thoracic endovascular aortic repair, is also available for people with thoracic aneurysms, which develop in the section of the aorta that travels through the chest.

Options for aneurysm repair

If you have an AAA, your vascular surgeon will likely recommend aneurysm surgery to prevent it from rupturing or tearing, which is known as aortic dissection.

The EVAR procedure can successfully treat many AAAs and can be a good option for people who can’t have an open aneurysm repair.

During EVAR, your vascular surgeon repairs your aneurysm through a small incision in the groin. The surgeon starts by inserting a thin tube called a catheter through the incision and guiding it to your aneurysm. The surgeon then sends a guide wire and a tiny mesh tube called a stent graft through the catheter. Once they’ve reached the aneurysm, your surgeon positions the stent graft in the aorta to direct blood flow away from the aneurysm.

A more complex form of EVAR called fenestrated EVAR, or FEVAR, works similarly. This procedure involves a graft designed to match the aorta and allows blood to flow through arteries that branch off the aorta.

FEVAR is a more complicated procedure than EVAR. While EVAR typically takes up to 2.5 hours to perform, FEVAR can take as long as eight hours.

Vascular surgeon discussing candidacy for endovascular aneurysm repair (EVAR) surgery with male patient

Who is a candidate for endovascular aneurysm repair?

Your vascular surgeon will consider many factors when determining whether you’re a candidate for EVAR or another surgery, including:

  • Other health conditions you may have
  • The anatomy of your arteries
  • The size and location of your aneurysm
  • Whether you have symptoms
  • Whether your aneurysm is expanding quickly

Benefits of EVAR

EVAR lowers the risk of aortic dissection when a tear develops in the inner layer of the aorta. As the stent graft strengthens the damaged area of the artery, less pressure is placed on the aneurysm, reducing the chances that it will rupture or tear.

EVAR and endograft repair are also minimally invasive procedures, which means the surgeon operates through several tiny incisions rather than the single large incision used in open heart surgeries.

What to expect during an EVAR procedure

Your care team will provide instructions about what to do in the days and weeks before your EVAR procedure. These instructions will include guidance about whether to take your medications and when to stop eating before the surgery.

Following AAA repair, you will typically remain in the hospital the next day for observation with minimally invasive procedures and a few days post-operation if undergoing an open surgery. Your vascular surgeon and other providers will monitor you for any potential signs of infection or other complications.

As you recover in the hospital, you'll be encouraged to get up and move around as soon as you can safely do so. When you're discharged, you'll receive another set of instructions to guide your at-home care.

Pay careful attention to these guidelines, including when you can resume normal activities, including work.

Prepare for your surgery

You can trust that your surgical team has your best interests at heart. Your surgeon can answer any questions you have, so you feel confident in your care.

Find a location near you

You can have EVAR and other forms of vascular surgery with an experienced team at our heart and vascular hospitals. You can receive comprehensive follow-up care at our many North and Central Texas locations. We want to ensure you continue receiving care at a location close to home.

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