Aortic aneurysm repair - endovascular

Definition

Endovascular abdominal aortic aneurysm repair is surgery to repair a widened area in your aorta, called an aneurysm. The aorta is the large artery that carries blood to your belly, pelvis, and legs.

An aortic aneurysm is when a part of this artery becomes too large or balloons outward due to weakness in the wall of the artery.

Alternative Names

EVAR; Endovascular aneurysm repair - aorta; AAA repair - endovascular; Repair - aortic aneurysm - endovascular

Description

You will lie on a padded table in an operating room, in the radiology department of the hospital, or in a catheterization lab. You may receive general anesthesia (you are asleep and pain-free) or epidural or spinal anesthesia.

Why the Procedure Is Performed

Endovascular aortic repair is done because your aneurysm is very large, growing quickly, or is leaking or bleeding.

You may have an abdominal aortic aneurysm that is not causing any symptoms or problems. Your doctor may have found out about this problem when you had an ultrasound or CT scan for another reason. There is a risk that this aneurysm may open up (rupture) if you do not have surgery to repair it. However, surgery to repair the aneurysm may also be risky. In such cases, endovascular repair is an option.

You and your doctor must decide whether the risk of having this surgery is smaller than the risk of rupture if you do not have surgery to repair the problem. The doctor is more likely to recommend that you have surgery if the aneurysm is:

Endovascular repair has a lower risk of complications compared to open surgery. Your doctor is more likely to suggest this type of repair if you have other, more serious medical problems or are elderly.

Risks

Risks for any surgery are:

Risks for this surgery are:

Before the Procedure

Your doctor will carefully examine you and order tests before you have surgery.

Always tell your doctor or nurse what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription.

If you are a smoker, you should stop. Your doctor or nurse can help. Here are other things you will need to do before your surgery:

The evening before your surgery:

On the day of your surgery:

After the Procedure

Most people stay in the hospital for 3 to 5 days after this surgery, depending on the type of procedure they had. Compared to open surgery, you should recover more quickly, have less pain, and go home sooner.

During a hospital stay, you may:

Outlook (Prognosis)

Recovery after endovascular repair is usually fairly quick.

You will need to be watched carefully over time for signs or symptoms that your repaired aortic aneurysm is leaking blood.

References

Tracci MC, Cherry JR KJ.  The Aorta. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap 62.

De Bruin JL, Baas AF, Buth J, Prinssen M, Verhoeven EL, Cuypers PW, et al: DREAM Study Group. Long-term outcome of open or endovascular repair of abdominal aortic aneurysm. N Engl J Med. 2010;362:1881-1889.

United Kingdom EVAR Trial Investigators, Greenhalgh RM, Brown LC, Powell JT, Thompson SG, Epstein D, Sculpher MJ. Endovascular versus open repair of abdominal aortic aneurysm. N Engl J Med. 2010;362:1863-1871.