Endovascular Aortic Aneurysm Repair (EVAR)

Endovascular aortic aneurysm repair (EVAR) is a minimally invasive surgical procedure used to treat an aortic aneurysm.

EVAR is particularly successful in treating an abdominal aortic aneurysm (AAA), which is a dangerous weakening and bulging of the body's largest artery. The primary goal of EVAR is to prevent the aneurysm from rupturing, which is often fatal. An aortic aneurysm is a bulge or balloon-like dilation that occurs in the aorta, which is the body's largest artery. The aorta carries oxygen-rich blood from the heart to the rest of the body.

Historically, aortic aneurysms were treated with open surgery, which involved a large incision, clamping the aorta, and surgically replacing the diseased segment with a synthetic graft. Medical innovations have allowed for EVAR to offer a less invasive alternative, making it suitable for many patients who might be considered high risk for open surgery.

Endovascular aortic aneurysm repair (EVAR): Why choose AHN?

AHN prioritizes a patient-first philosophy, which means tailoring care to meet you and your unique needs. When facing the diagnosis of an aortic aneurysm and considering advanced treatment options like EVAR, a health care partner with proven expertise and a compassionate, measured approach make all the difference.

AHN is a leading choice for EVAR, offering state-of-the-art care that prioritizes your safety, recovery, and long-term well-being. Choosing AHN for your EVAR procedure means: 

  • Leading expertise from renowned vascular surgeons: You will see highly experienced, board-certified vascular surgeons who are leaders in both open and endovascular aortic repair. This ensures that you receive an accurate diagnosis and a personalized treatment recommendation based on a deep understanding of all available options for your specific aneurysm anatomy. Our surgeons regularly perform a high volume of complex EVAR procedures, reflecting AHN's dedication to leading-edge vascular treatment and superior patient safety.
  • Advanced technology and hybrid operating suites: AHN is equipped with the most advanced imaging and navigational technologies crucial for the precision required in EVAR. This includes cutting-edge medical imaging like fluoroscopy and 3D imaging capabilities. We use hybrid operating rooms, which combine the sterile environment of a traditional operating room with advanced imaging equipment. This allows our surgeons to perform complex EVAR procedures, including those requiring more involved surgeries, with unparalleled safety and efficiency.
  • Comprehensive aneurysm program with lifelong follow-up: Our care extends beyond the procedure itself. We offer a robust aneurysm surveillance program, providing the crucial, lifelong follow-up necessary to monitor your stent graft and detect any potential issues early. Our team meticulously manages your post-procedural care, allowing greater peace of mind. We provide comprehensive management of associated risk factors for aneurysm growth and cardiovascular disease, addressing your overall health in an effort to prevent future issues.
  • Multidisciplinary collaboration for complex cases: For patients with complex aortic aneurysms or those with multiple comorbidities, our vascular surgeons collaborate closely with interventional cardiologists, cardiac surgeons, radiologists, and critical care specialists. This integrated approach helps coordinate every aspect of your care, which is particularly important for high-risk individuals.
  • Patient-centered experience and rapid recovery focus: We understand that undergoing a significant procedure can be daunting. Our team prioritizes patient education, to help you gain a full understanding of EVAR, its benefits, risks, and recovery pathway. The minimally invasive nature of EVAR at AHN, combined with our dedicated postoperative care, supports faster recovery times, less pain, and a quicker return to your daily activities compared to open surgery.
  • Commitment to research and innovation: As part of a leading health care institution, AHN actively participates in clinical trials and implements the latest advancements in endovascular technology. This means our eligible patients have access to cutting-edge stent graft devices and techniques.

At AHN, choosing EVAR means choosing a team dedicated to excellence, safety, and your long-term vascular health. We are here to guide you through every step of your journey, providing compassionate, world-class care.

What to expect for an EVAR procedure

The EVAR procedure is a minimally invasive surgery that is performed in an AHN hospital setting. Prior to the surgery, your AHN care team will give you specific instructions to follow to prep for the surgery. There may be modifications to your medications or diet.  Your provider will also do a full health exam to ensure you are ready for the surgery. Here are some things to know about an EVAR procedure that will help you feel confident going into it:

  • Preoperative preparation: You will change into a hospital gown. A nurse will start an IV line to administer fluids and medications. You will also meet with the surgical team, including the surgeon and anesthesiologist, who will answer any last-minute questions and discuss the procedure.
  • Anesthesia: You will receive either general anesthesia, which will put you to sleep, or local anesthesia with sedation, which will numb the surgical area and help you relax.
  • The procedure: The EVAR procedure involves making small incisions, usually in both groins. Through these incisions, the surgeon will insert thin, flexible tubes called catheters into the femoral arteries. Using X-ray guidance, a stent graft (a fabric-covered metal tube) will be guided through the arteries to the site of the aneurysm. The stent graft is then precisely deployed within the aorta, relining the weakened area and creating a new pathway for blood flow, effectively bypassing the aneurysm and preventing it from rupturing.
  • Procedure duration: An EVAR procedure typically takes two to four hours to complete, though this can vary depending on the complexity of the aneurysm and the individual patient.

EVAR recovery

Recovery from an EVAR procedure will vary for everyone. It’s important to remember that patience and following post-care instructions from your AHN care team will help you get back to feeling fully recovered sooner. Immediately after your surgery, you will spend some time in a recovery room where you will be closely monitored as you come out from under anesthesia. 

Once you regain full awareness, you will move to general recovery where your pain will be managed, and your progress will continue to be monitored. You may have an IV where fluids and pain medication will be administered. You also might have a catheter. Once you’ve been cleared to do so, activity will be encouraged that will help in your recovery. Once you have been cleared for discharge, which is usually one to three days post-op, you can go home. 

At home, a mix of rest and restorative activity is encouraged. You’ll want to avoid lifting heavy objects and strenuous activity. But including some walking and light activity is good for your circulation and overall health. Your AHN care team will give you your specific at home plan, so you can feel confident in your recovery journey. 

EVAR FAQs

For many, the idea of having this procedure may be scary or overwhelming. At AHN, we understand the emotions that come with having procedures and are focused on helping you find resources and support that will make your experience less worrisome. Your AHN care team is available to answer any and all questions you may have, and, in the meantime, these frequently asked questions may help you feel a little more informed. You can use these as a starting point in future conversations with your care team.

What is the recovery time for endovascular aortic aneurysm repair?

The recovery time for endovascular aortic aneurysm repair (EVAR) is generally shorter compared to traditional open surgery. Most patients can expect to be in the hospital for one to three days after the procedure. Full recovery and return to normal activities typically take two to six weeks, though this can vary based on individual factors like overall health, age, and any complications. Patients are usually advised to avoid heavy lifting and strenuous activities for a few weeks.

What is endovascular repair for abdominal aortic aneurysm?

Endovascular repair for an abdominal aortic aneurysm (AAA), also known as EVAR, is a minimally invasive procedure used to treat an enlarged or weakened area in the aorta, the body's main artery, located in the abdomen. Instead of a large incision, surgeons make small incisions, usually in the groin, to access the femoral arteries. Through these incisions, a catheter is guided to the aneurysm site. A stent-graft, a fabric tube supported by a metal mesh, is then delivered and deployed within the aneurysm to reinforce the weakened artery wall and redirect blood flow, preventing the aneurysm from rupturing.

What to expect at home after endovascular aortic aneurysm repair

After returning home from an EVAR procedure, patients can expect the following:

  • Pain and discomfort: Mild pain, bruising, and tenderness at the incision sites in the groin are common. Over-the-counter pain relievers or prescribed medications can help manage this discomfort. 
  • Activity restrictions: Patients will typically be advised to avoid heavy lifting (usually anything over five to 10 pounds), strenuous exercise, and prolonged standing for several weeks. Gradual increase in activity is encouraged.
  • Wound care: Keeping the incision sites clean and dry is crucial to prevent infection. Specific instructions on dressing changes and signs of infection will be provided.
  • Follow-up appointments: Regular follow-up appointments with the surgeon, including imaging tests (like CT scans), are essential to monitor the stent graft and ensure the aneurysm is stable. These follow-ups usually occur at one month, six months, and then annually.
  • Medications: Patients may need to take blood thinners or other medications as prescribed to prevent blood clots.
  • Potential complications: While rare, it's important to be aware of signs of potential complications such as fever, increasing pain, redness or swelling at the incision site, numbness or tingling in the legs, or unexpected bleeding. Patients should contact their doctor immediately if they experience any of these.

Contact us

Call (412) DOCTORS 412-362-8677 to schedule an appointment with a specialist if you have not yet been evaluated for or diagnosed with a heart condition yet. To schedule an EVAR procedure with a vascular surgeon, call 412-359-8820.