Endovascular aneurysm repair (EVAR) transformed the management of abdominal aortic aneurysms by replacing a large open operation with a catheter-based procedure. A stent graft is delivered through the femoral arteries and deployed across the aneurysm, excluding the sac from arterial pressure while preserving flow through the graft lumen.
Procedure principles
Success depends on adequate proximal and distal landing zones where the graft seals against healthy aorta and iliac arteries. The device is delivered over stiff guidewires under fluoroscopic guidance, with precise deployment at the renal arteries to maximize seal without covering vital branches. Completion angiography confirms exclusion and identifies any endoleak.
Anatomic requirements and advances
- Standard infrarenal EVAR requires a suitable neck length, diameter, and angulation.
- Fenestrated and branched devices extend endovascular repair to juxtarenal and thoracoabdominal aneurysms by incorporating openings for visceral vessels.
- Flow-modulating approaches aim to preserve branch perfusion in complex anatomy.
- Percutaneous access with closure devices has reduced the invasiveness of the femoral approach.
Outcomes
Compared with open repair, EVAR offers lower early morbidity and faster recovery in suitable patients, with long-term durability dependent on seal integrity and freedom from endoleak. Because these can evolve over years, lifelong imaging surveillance is an integral part of EVAR care.
Patient selection
Selection weighs anatomy, life expectancy, and the ability to comply with surveillance. A multidisciplinary aortic team matches device strategy — standard, fenestrated, branched, or open — to the individual anatomy and risk profile.
INVAMED technologies in this space
INVAMED's aortic portfolio includes the ATLAS stent-graft family and the Stena Multilayer Flow Modulator; explore the aortic aneurysm and dissection repair category.
Device availability and approved indications vary by country. This content is prepared for healthcare professionals and does not replace clinical judgment or the instructions for use.