The aorta is the largest artery in the body. The abdominal part of the aorta is located below the diaphragm. It carries blood to the abdomen, pelvis, and legs. Sometimes, the walls of the aorta weaken and bulge in one area. This is called an abdominal aortic aneurysm (AAA). When the aneurysm reaches a certain size, it may need to be repaired. Endovascular repair of an AAA (EVAR) is done from the inside of the artery. A stent graft is inserted into the area to strengthen it.
This procedure is often done to repair AAA when the aneurysm:
EVAR is now the preferred method to treat AAA. EVAR can result in less pain, shorter hospital stay, fewer complications, and faster recovery time compared to open surgery. However, closer follow-up over many years is needed.
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:
Your risk of complications may also be increased if you have had:
Your doctor may:
Before the procedure:
Your doctor may use:
You will lie on your back. Small incisions will be made in both sides of the groin. Thin tubes called catheters will be inserted into the blood vessels and threaded up toward the aneurysm. Contrast dye will be injected through the catheters. A stent graft will be guided to the site. The graft will be placed into the weakened area and extended into both pelvic arteries. X-ray images will be used to guide each step. Once the graft is in place, the catheters will be removed. The incisions will be closed. Sterile bandages will be applied.
You will be taken to the intensive care unit (ICU). If you have a breathing tube, it will be removed. Your vital signs will be closely monitored.
About 2-3 hours
Anesthesia will prevent pain during the procedure. Your doctor will give you medication to manage the pain during the recovery process. There is little discomfort from the groin incisions.
The usual length of stay is 1-2 days. Your doctor may choose to keep you longer if needed.
At the hospital, you will:
During your stay, the hospital staff will take steps to reduce your chance of infection such as:
There are also steps you can take to reduce your chances of infection such as:
To help prevent further problems, you and your doctor will need to work to increase your overall health. This can be done with medications and a healthy lifestyle. If you are a smoker, you should talk to your doctor about quitting.
Call your doctor if any of the following occur:
Call for emergency medical services or go to the emergency room right away if you have:
If you think you have an emergency, call for emergency medical services right away.
American Heart Association
Society for Vascular Surgery
Heart and Stroke Foundation of Canada
University of Ottawa Heart Institute
Abdominal aortic aneurysm (AAA). EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T114361/Abdominal-aortic-aneurysm-AAA. Updated January 11, 2018. Accessed March 1, 2018.
Endovascular repair of abdominal aortic aneurysms. Society for Vascular Surgery website. Available at: https://vascular.org/patient-resources/vascular-treatments/endovascular-repair-abdominal-aortic-aneurysms. Accessed March 1, 2018.
Endovascular repair of thoracic aortic aneurysms. Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/treatments/16962-endovascular-repair-of-thoracic-aortic-aneurysms. Updated September 2016. Accessed March 1, 2018.
Fotis T, Mitsos A, Perdikides T, et al. Regional Anesthesia versus general anesthesia in endovascular aneurism repair: the surgical nursing interventions. British Journal of Anesthetic and Recovery Nursing. 2009;10(1):11-14.
Last reviewed March 2018 by EBSCO Medical Review Board Michael J. Fucci, DO, FACC Last Updated: 1/27/2014