Understanding how EVAR surgery works can help patients feel more informed before a scheduled procedure or when discussing options with a physician. Endovascular aortic aneurysm repair (EVAR) is a minimally invasive technique used to treat abdominal aortic aneurysms by placing a stent graft inside the aorta through small incisions, rather than through open abdominal surgery. This guide walks through the general steps involved.
What Is EVAR Designed to Do?
EVAR is designed to redirect blood flow through a stent graft placed inside the aneurysm, reducing pressure on the weakened, bulging section of the aortic wall. By excluding the aneurysm sac from direct arterial blood flow and pressure, the goal is to reduce the risk of continued aneurysm growth or rupture over time. As with any procedure, outcomes vary by individual, and suitability for EVAR is determined by a physician based on aneurysm anatomy and overall health.
What Happens Before the Procedure?
Before EVAR, a physician typically orders detailed CT angiography imaging to measure the aneurysm and map the surrounding blood vessel anatomy. This planning stage allows the care team to select an appropriately sized stent graft and determine the safest access approach for the individual patient's anatomy.
How Is EVAR Performed Step by Step?
While specific technique varies by case and physician, EVAR generally follows these general steps:
- Vascular access — Small incisions or needle punctures are made, typically in both groins, to access the femoral arteries.
- Guidewire and catheter navigation — Using X-ray (fluoroscopic) guidance, a guidewire and delivery catheter are advanced through the blood vessels to the site of the aneurysm.
- Stent graft delivery — A compressed, covered stent graft is advanced through the delivery system to the treatment site within the aorta.
- Deployment — The stent graft is released and expands into place, forming a new, sealed conduit for blood flow that bypasses the aneurysm sac.
- Sealing and fixation confirmation — The physician uses imaging to confirm proper graft position, seal, and blood flow, checking for any signs of endoleak.
- Closure — Access sites are closed, often using closure devices or sutures, and the patient is moved to recovery.
The entire procedure is typically performed with the patient under general, regional, or local anesthesia with sedation, depending on the case and anesthesia team's assessment.
What Happens After the Procedure?
Recovery from EVAR is generally shorter than recovery from open surgical repair, given its minimally invasive nature, though individual recovery timelines vary. Patients are typically monitored in the hospital briefly before discharge, and long-term follow-up imaging is scheduled to check for endoleak and confirm the aneurysm sac remains stable over time. All procedures carry risks, and a physician will discuss what to expect based on the individual case.
Frequently Asked Questions
Is EVAR suitable for every abdominal aortic aneurysm?
No, suitability depends on aneurysm anatomy, including the shape and length of the aortic segments above and below the aneurysm. A physician evaluates imaging to determine whether a patient's anatomy is appropriate for an endovascular approach or whether open repair may be more suitable.
How long does EVAR typically take?
Procedure duration varies based on aneurysm complexity and anatomy, and a physician can provide a more specific estimate based on the individual case and planned approach.
Will I need follow-up after EVAR?
Yes, long-term surveillance imaging is a standard part of care after EVAR to monitor the stent graft position and check for endoleak or aneurysm sac size changes over time.
Related INVAMED Resources
- Aortic Aneurysm & Dissection Repair — explore INVAMED's stent graft technologies used in endovascular aortic repair.
- Comprehensive Catheter & Guidewire Systems — devices supporting endovascular access procedures.
- Request Information — contact INVAMED to learn more.
Medical Disclaimer: This article is provided for general informational and educational purposes only and does not constitute medical advice, diagnosis, or treatment recommendation. It is not a substitute for consultation with a qualified healthcare professional. Product indications, availability, and regulatory status vary by country. Always refer to the official Instructions for Use (IFU) and consult a licensed physician for guidance specific to your situation. INVAMED devices are intended for use by trained healthcare professionals.