Endovascular Aortic Aneurysm Repair: Benefits, Causes, and Procedure

Endovascular Aneurysm Repair (EVAR) is a minimally invasive procedure. It treats the condition of abdominal aortic aneurysm (AAA). AAA EVAR repair reduces the risk of open surgery and offers less pain and faster healing.

CureIndia expert surgeons do EVAR procedures efficiently. They help patients manage their cardiac illnesses, so they can live happy and regular lives.

What is an Abdominal Aortic Aneurysm (AAA)?

The aorta is the largest artery in our body. It begins at the base of our heart and extends through the chest, and it ends in the abdomen. The portion that connects with our belly is called the abdominal aorta. This aorta carries oxygen-rich blood from the heart to the abdomen, pelvis, and legs.

An aneurysm is the medical term used for the swelling of the aorta. The walls of the aorta can swell or bulge like a balloon if it becomes weak. The condition is known as Abdominal Aortic Aneurysm when it occurs in the abdominal part of the aorta.

In a rare case, an aneurysm of less than 5.5 cm in diameter bursts. The risk is less than 1 in 100 per year. However, an aneurysm of 5.5 cm and larger is more likely to rupture. It is usually at this size that surgery is suggested. Each individual’s risk from their AAA and surgery will be different.

Abdominal Aortic Aneurysm (AAA) does not always cause a problem. However, increasing growth of the aorta in the abdomen can rupture and cause severe bleeding. This bleeding can cause shock or death.

Symptoms of Abdominal Aortic Aneurysm (AAA)

Abdominal aortic aneurysm (AAA) grows slowly. Therefore, often AAA does not show any symptoms. Hence, generally, the disease is left undetected. Some aneurysms never grow and remain the same without rupturing. However, other aneurysms grow, and rupture risks life. Here are the symptoms of abdominal aortic aneurysm (AAA) one should consider.

• Deep and consistent pain in the belly area or one side of the belly
• Constant back pain
• A pulse near the belly button

Who Requires Endovascular Aneurysm Repair?

People who have cardiovascular issues are at risk of developing abdominal aortic aneurysm. Thus, they require AAA EVAR repair. Here are some conditions that develop the risk of AAA.

• Coronary Artery Disease
• Peripheral Artery Disease
• High blood pressure
• High cholesterol
• Obesity or overweight
• Smoking
• Due to aging
• Suffering from certain infection
• Certain congenital conditions

Is there any alternative for EVAR?

Currently, no alternatives or medications are available. No medicines can strengthen the wall of the aorta.

An open surgery can repair an aneurysm. It involves a large cut in the abdomen (from top to bottom). Then they will replace the weakened aorta with a tube. However, open surgery is not suitable in all cases. Hence, it is necessary to talk with a specialist. The specialist will suggest a better way of abdominal aortic aneurysm repair.

Advantages of Endovascular Aortic Aneurysm Repair

The abdominal aortic aneurysm endovascular surgery is minimally invasive. Hence, the procedure is more advantageous than an open surgery. However, the specialist can only suggest a suitable surgery procedure. The advantage include:

• Quick recovery after surgery
• Less blood loss
• Quick return to regular activities
• Less discomfort
• Reduced risk of having a heart attack during the EVAR procedure.

Candidacy for Endovascular Aortic Aneurysm Repair (EVAR)

If you have an abdominal aortic aneurysm, you may have candidacy for Endovascular Repair. However, a specialist can suggest the procedure after tests & diagnosis. You may have candidacy for EVAR if you have:

• A rapidly growing smaller or larger aneurysm
• Not qualified for open surgery or larger incision
• Healthy vessel tissue near the aneurysm

The Tests and Examinations Before EVAR

Here are the following tests and examinations done before doing the EVAR procedure.

Blood test: To detect anemia or infections

Electrocardiography: This test will check the size of the aneurysm

Electrocardiogram (ECG): Check the heart rhythm

Angiography: Provides details of aneurysm

CT Scan: Creates a detailed image of the aneurysm

How does Endovascular Aortic Aneurysm Repair (EVAR) work?

After an expert finds you a suitable candidate for endovascular aortic aneurysm repair, you can expect the below procedures during surgery.

1. At first, anesthesia given to you helps you fall asleep or relax. It will help you relax during the procedure without any discomfort or pain.
2. The expert then uses arteries near the groin region called femoral arteries. It will help with accessing abdominal aortic aneurysms.
3. Next, the expert will insert a catheter that contains a low profile and expendable stent graft. The catheter is then guided through the arteries to reach the aneurysm.
4. After reaching the aorta, the stent opens and fastens the place. So, the blood flows through it. It also prevents aneurysms from bursting.
5. Completing the procedure, the specialist will close the incision using a small bandage.

Recovery After Endovascular Aortic Aneurysm Repair (EVAR) Procedure

Patients who underwent an EVAR procedure are required to stay one to three days in the hospital. After EVAR, eating and drinking are abstained until the patient is awake from the sedation. When patients can sit or stand, they can leave for home. The expert doctor will prescribe some medications along with painkillers.  

In most cases, the patient fully recovers after the EVAR procedure within two weeks. They also can return to their work. However, older people may need more time to recover. For older people, it may take a month or more to fully recover after endovascular repair surgery. It is suggested to improve activities gradually through the recovery period.

What is Fenestrated Endovascular Aneurysm Repair (FEVAR)?

Fenestrated endovascular aneurysm repair (FEVAR) is a specialized technique that repairs complex aneurysms. The procedure supports both the aorta and arteries that split off to the kidneys and heart. The abdominal aorta has many branches that carry blood to the organs in our belly. FEVAR is required when an aneurysm happens in one of those branches.

Grafts with small openings are being utilized in FEVAR (Fenestrated Endovascular Aneurysm Repair). FDA has approved the FEVAR technique. The special device for FEVAR fits into the tree branches like the structure of the aorta. Depending on the location of the aneurysm, the specialist may suggest FEVAR.

What is the Difference Between TEVAR and EVAR?

The full form of TEVAR is Thoracic endovascular aneurysm repair. TEVAR fits to treat the aneurysm situated in the thorax or chest. On the other hand, EVAR treats the aneurysm near the belly. TEVAR is specially fit for treating the descending aorta. The descending aorta is the part of the aorta that moves to the abdomen through your chest.

Endovascular Aneurysm Repair Surgery FAQs