This article compares two approaches side by side to clarify how they differ in principle and practice. Repair strategy depends on the segment involved, with distinct considerations for the abdominal aorta below the kidneys and the thoracic aorta in the chest. As a medical device manufacturer, INVAMED develops technologies in this area; the information here is educational and not medical advice.
Background: Aortic Aneurysm and Dissection Endovascular Repair
Whether an aneurysm meets criteria for repair, and by which technique, is determined by the vascular specialist using appropriate imaging and current thresholds. Thoracic endovascular aortic repair (TEVAR) treats thoracic aortic aneurysms with a stent graft placed in the descending thoracic aorta. Repair strategy depends on the segment involved, with distinct considerations for the abdominal aorta below the kidneys and the thoracic aorta in the chest.
EVAR vs Open surgical repair: Key Differences
EVAR repairs an abdominal aortic aneurysm from within the vessel through the femoral arteries, whereas open repair replaces the diseased segment with a surgical graft via a large incision. EVAR is associated with less short-term morbidity and faster initial recovery, while open repair avoids the lifelong imaging surveillance that endovascular grafts require. Anatomic suitability, particularly the quality of the aneurysm neck, strongly influences whether EVAR is feasible. The choice is individualized by the surgical and vascular team based on anatomy and overall risk.
How INVAMED Supports Both Approaches
Device availability and regulatory status vary by country. Please contact INVAMED or your authorized local distributor for current regulatory information applicable to your region.
Key Considerations
- Aneurysm-neck quality and landing-zone length strongly influence whether a covered graft, a flow modulator, or open surgery is most appropriate.
- Lifelong imaging surveillance is a standard requirement after endovascular repair to detect endoleak or migration.
- Manufacturer descriptions of flow modulation and radial support reflect design intent rather than guaranteed clinical outcomes.
Frequently Asked Questions
What is the difference between EVAR and TEVAR?
EVAR treats infrarenal abdominal aortic aneurysms with bifurcated modular endografts, while TEVAR treats thoracic aortic aneurysms with a stent graft in the descending thoracic aorta.
What is the INVAMED flow modulator called?
INVAMED's flow-modulating aortic device is the STENA Aortic Multi-Layer Flow Modulator, a self-expanding multilayer braided scaffold intended to preserve branch vessels.
Does the flow modulator cover branch vessels?
INVAMED describes the STENA MFM as branch-preserving, designed to modulate blood flow without covering branch vessels; suitability is determined by the clinician.
Clinical and Technical Context
Branch-vessel involvement may steer selection toward branch-preserving strategies such as the multilayer flow modulator. Accurate, calibrated cross-sectional imaging is essential for sizing, oversizing, and defining adequate sealing zones before an endovascular repair. All INVAMED aortic devices are intended for use by trained vascular specialists under imaging guidance and per the IFU. Suitability for a flow-modulating approach is highly anatomy-dependent and is determined by the vascular specialist. INVAMED's STENA Aortic Multi-Layer Flow Modulator uses a 3D-braided five-layer superalloy design with a micro-porous mesh intended to optimize laminar flow while maintaining radial support and conformability. Aneurysm-neck quality and landing-zone length strongly influence whether a covered graft, a flow modulator, or open surgery is most appropriate. Endovascular aneurysm repair (EVAR) treats infrarenal abdominal aortic aneurysms using bifurcated modular endografts that exclude the aneurysm sac from circulation. Thoracic endovascular aortic repair (TEVAR) treats thoracic aortic aneurysms with a stent graft placed in the descending thoracic aorta.
Related on INVAMED
- Aortic Aneurysm & Dissection Repair — product category
- What size aneurysm requires surgery?
- Multilayer Flow Modulator (MFM): How It Works and Why It Matters
- Endoleak Surveillance After Repair: Technology, Uses and Considerations
Important Disclaimer
This article is intended for general educational and technical information about medical device technologies. It is not medical advice, a diagnosis, or a treatment recommendation, and it does not replace consultation with a qualified healthcare professional. Any decision about diagnosis or treatment should be made by a licensed clinician based on an individual assessment. INVAMED devices are intended for use by trained healthcare professionals in accordance with the applicable Instructions for Use (IFU) and local regulatory approvals. Product availability and indications vary by country.
Reviewed by the INVAMED Medical Affairs team. Content is educational and technical in nature.