(Minimally Invasive Repair of Abdominal Aortic Aneurysm; EVAR)
Deanna M. Neff, MPH
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
(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. The doctor inserts a stent graft into the area to strengthen it.
This procedure is often done to repair AAA when the aneurysm:
Causes physical symptoms (eg, abdominal pain)
Causes complications (eg, clots that travel into the legs)
Reaches a certain size and position that meets criteria for EVAR
Has burst—Surgery must be done right away.
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.
You will lie on your back. You will receive medicine to ease pain and relax you. Once you are asleep and sedated, a breathing tube will be inserted into your throat and lungs. Sometimes, regional anesthesia will be used. A breathing tube will not be needed in this case.
The doctor will make small incisions in both sides of the groin. Catheters (thin tubes) will be inserted into the blood vessels and threaded up toward the aneurysm. Contrast dye will be injected through the catheters. The doctor will then guide a stent graft to the site. The graft will be placed into the weakened area and extended into both pelvic arteries. To guide each step, the doctor will use live x-ray images. Your vital signs will be monitored. Once the graft is in place, the doctor will remove the catheters. The incisions will be closed. Sterile bandages will be applied.
Immediately After Procedure
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.
How Long Will It Take?
About 2-3 hours
How Much Will It Hurt?
Anesthesia will prevent pain during the procedure. Your doctor will give you medicine to manage the pain during the recovery process. There is little discomfort from the groin incisions.
Average Hospital Stay
The usual length of stay is 1-2 days. Your doctor may choose to keep you longer if needed.
At the Hospital
At the hospital, you will:
Gradually move around and increase your activity level
Slowly return to eating solid foods, as tolerated
During your stay, the hospital staff will take steps to reduce your chance of infection such as:
Washing their hands
Wearing gloves or masks
Keeping your incisions covered
There are also steps you can take to reduce your chances of infection such as:
Washing your hands often and reminding visitors and healthcare providers to do the same
Reminding your healthcare providers to wear gloves or masks
Not allowing others to touch your incisions
When you return home, do the following to help ensure a smooth recovery:
Keep the incision areas clean and dry. Follow your doctor’s instructions for changing your bandages.
Ask your doctor about when it is safe to shower, bathe, or soak in water.
Take pain medicine as directed.
Ask your doctor which activities are safe for you.
Your condition needs to be carefully monitored. Be sure to go to all of your appointments.
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