Endovascular Aortic Aneurysm Repair
How Does Endovascular Aortic Aneurysm Repair Work?
Endovascular Aortic Aneurysm Repair (EVAR) is a state-of-the-art, minimally invasive procedure used to treat aortic aneurysms, which are weakened, bulging areas in the aorta that can pose serious health risks if left untreated. During EVAR, a small incision is made in the groin area, allowing the surgeon to guide a thin, flexible catheter through the blood vessels to the site of the aneurysm. A stent graft—made of a strong fabric and metal mesh—is then positioned within the affected section of the aorta to reinforce its walls and redirect blood flow, effectively reducing the risk of rupture. The procedure is performed under imaging guidance to ensure precision and accuracy, often taking just a few hours.
Compared to traditional open heart surgery, EVAR avoids the need for extensive surgical exposure, making it an excellent option for patients who may not tolerate major surgery well. Additionally, patients undergoing EVAR typically experience less pain, shorter hospital stays, and quicker returns to normal activities.
Risks & Benefits of Endovascular Aortic Aneurysm Repair
Benefits
- Lower Mortality Rate: Studies show EVAR is associated with reduced short-term mortality compared to open surgery, especially in high-risk patients.
- Minimally Invasive Approach: EVAR requires small incisions, resulting in less pain and scarring compared to open surgery.
- Precision Treatment: Advanced imaging ensures the stent graft is placed accurately to stabilize the aneurysm and reduce the risk of rupture.
- Reduced Risk of Complications: Smaller incisions and less tissue disruption lower the risks of infection, bleeding, and other surgical complications.
- Shorter Recovery Time: Patients often leave the hospital within a day or two and can resume normal activities more quickly.
- Suitability for High-Risk Patients: EVAR is a safer alternative for individuals who may not be candidates for open surgery due to age, other health conditions, or frailty.
Risks
- Bleeding or Vascular Injury: The procedure may cause damage to surrounding blood vessels during catheter insertion or placement.
- Contrast Dye Reactions: Some patients, particularly those with kidney issues or dye allergies, may experience adverse reactions to the contrast dye used during imaging.
- Device Migration or Malfunction: Over time, the stent graft may move or fail to function as intended, requiring follow-up procedures.
- Endoleak: Blood may continue to flow into the aneurysm sac if the stent graft doesn’t seal completely.
- Need for Regular Monitoring: Patients typically require lifelong imaging to ensure the graft remains in place and the aneurysm stays stable.
- Risk of Infection: Though rare, infections can occur at the incision site or around the graft.
What to Expect During Endovascular Aortic Aneurysm Repair
Before the Surgery
Before undergoing EVAR at TCAVI, you will have a detailed consultation with our vascular specialists to assess your overall health and the size and location of the aneurysm. This includes imaging studies, such as a CT scan, to map your blood vessels and plan the procedure precisely. You’ll receive pre-operative instructions, including guidelines on eating, drinking, and managing medications. Our team will ensure you’re fully informed about the procedure and comfortable with what to expect.
After the Procedure
On the day of the procedure, you’ll be placed under local or general anesthesia, depending on your specific needs. The surgeon will make a small incision near the groin and insert a catheter to guide the stent graft to the aneurysm site. Using real-time imaging, the graft is carefully positioned and deployed to reinforce the weakened area of the aorta. The procedure typically takes 2–3 hours, and once complete, the incisions are closed, and you’ll be moved to a recovery area.
Before the Surgery
Following EVAR, most patients spend one to two days in the hospital for observation. You’ll be monitored for any signs of complications and provided with detailed instructions for recovery, including activity restrictions and follow-up care. Many patients can return to their normal routines within a week or two. At TCAVI, we prioritize ongoing care, so regular imaging check-ups will be scheduled to ensure the stent graft is functioning properly and the aneurysm remains stable. Our team is always available to support you throughout your recovery.
Am I a Candidate for Endovascular Aortic Aneurysm Repair?
- High-Risk Patients for Open Surgery: Patients who may not tolerate open surgery due to advanced age, pre-existing medical conditions, or other factors that increase surgical risks.
- Individuals with Peripheral Artery Disease (PAD): Patients whose vascular health and anatomy are suitable for minimally invasive approaches, particularly if the aneurysm impacts peripheral circulation.
- Patients with Abdominal Aortic Aneurysms (AAA): Individuals diagnosed with an aneurysm in the abdominal aorta that meets the criteria for repair (typically greater than 5.5 cm in diameter or rapidly growing).
- Patients with Thoracic Aortic Aneurysms (TAA): Those with aneurysms in the thoracic section of the aorta that pose a risk of rupture or dissection.
- Patients Experiencing Symptoms of Aneurysm: Those experiencing symptoms such as back or abdominal pain caused by the aneurysm, signaling an increased risk of rupture.
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