Last Updated on November 26, 2025 by Bilal Hasdemir

If you have an abdominal aortic aneurysm (AAA), knowing your treatment options is key. Endovascular Aortic Aneurysm Repair (EVAR) is a new, less invasive way to treat AAA.

At Liv Hospital, we put your safety and well-being first. We offer EVAR surgery with a focus on you. Our team is committed to top-notch care and innovative procedures. This article will explain EVAR, its benefits, and important terms to help you make the best choice for your health.

Key Takeaways

• EVAR is a minimally invasive procedure for treating abdominal aortic aneurysms.
• The procedure involves introducing a stent-graft through the blood vessels to repair the aneurysm.
• EVAR offers several benefits, including reduced recovery time and lower risk of complications.
• Understanding the key terms associated with EVAR can help patients better navigate their treatment options.
• Liv Hospital’s expert team provides patient-focused care and innovative EVAR procedures.

What is EVAR Surgery?

EVAR surgery, or Endovascular Aneurysm Repair, is a new way to treat abdominal aortic aneurysms (AAA) with less invasion. It has changed how we manage aortic aneurysms. Now, patients have a safer option than traditional open surgery.

Definition and Purpose

EVAR surgery uses a stent-graft placed in the aorta through small groin incisions. It’s guided to the aneurysm site using imaging. The stent-graft strengthens the artery wall, stopping the aneurysm from growing or rupturing.

Key benefits of EVAR include:

• Minimally invasive approach, reducing recovery time
• Less risk of complications compared to open surgery
• Ability to treat patients who are not suitable for open surgery due to comorbidities

Historical Development of EVAR

The idea of EVAR started in the 1980s. But it wasn’t until the 1990s that it became more accepted. Thanks to better stent-grafts and imaging, EVAR has become a reliable treatment.

Year	Milestone
1980s	Concept of EVAR first introduced
1990s	EVAR technique gains acceptance; first-generation stent-grafts used
2000s	Advancements in stent-graft technology and imaging techniques

Now, EVAR is a key treatment for abdominal aortic aneurysms. Research continues to make it even better and help more patients.

Understanding Abdominal Aortic Aneurysms (AAA)

An Abdominal Aortic Aneurysm (AAA) happens when the aorta, the main blood vessel, bulges or weakens in the belly. This is a serious condition that needs quick medical help.

AAA often doesn’t show symptoms, so it’s key to know its causes, risks, and how common it is. This helps find and treat it early.

Causes of Aortic Aneurysm

The exact reason for an aortic aneurysm isn’t always known. But, several things can make it happen. Weakening of the arterial wall is a big factor, often from a mix of genes and lifestyle.

Some specific reasons include:

• Atherosclerosis, or the buildup of plaque in the arteries
• High blood pressure, which can put extra strain on the aortic wall
• Genetic predisposition, with a family history of aneurysms increasing the risk
• Smoking, which significantly increases the risk of developing an aneurysm

Risk Factors and Prevalence

There are several risk factors for AAA. These include:

Risk Factor	Description
Age	Risk increases with age, specially after 65
Gender	Men are more likely to develop AAA than women
Smoking History	Smokers are at a significantly higher risk
Family History	A history of AAA in first-degree relatives increases risk

AAA is more common in older adults, mainly men. Screening is advised for men aged 65 to 75 who have ever smoked.

Knowing the risk factors and causes of AAA is key for prevention and early detection. By spotting high-risk individuals, doctors can offer targeted screening and prevention.

EVAR vs. Traditional Open Surgery

There are two main ways to treat Abdominal Aortic Aneurysms (AAA): EVAR surgery and traditional open surgery. The choice depends on the patient’s health, the aneurysm’s size, and the surgeon’s skill.

Key Differences in Approach

EVAR surgery is a minimally invasive procedure. It uses a stent-graft inserted through the femoral arteries in the groin. This method avoids a big abdominal incision, leading to quicker recovery. Traditional open surgery, on the other hand, requires a large incision in the abdomen to directly access the aorta.

A study on the National Center for Biotechnology Information website shows EVAR is now the main choice for AAA repair. It’s used in over 75 percent of cases in many countries. This is because EVAR has lower risks and complications compared to open surgery.

Comparative Outcomes and Statistics

Studies show EVAR surgery has lower perioperative mortality rates and fewer complications than open surgery. A meta-analysis found EVAR patients have shorter hospital stays and fewer ICU admissions.

But, EVAR comes with its own set of challenges. It needs precise planning and a skilled team for success. Also, long-term monitoring is key to catch any complications like endoleaks or stent-graft migration.

“The use of EVAR has revolutionized the treatment of AAA, making it a less invasive option compared to traditional open repair. As technology improves, we can expect better outcomes for EVAR patients.”

In summary, while both EVAR and open surgery are used for AAA treatment, EVAR is preferred for many patients. As vascular surgery advances, understanding the differences between these methods is key for the best patient care.

The EVAR Procedure Explained Step by Step

The EVAR procedure is a series of steps to treat abdominal aortic aneurysms. It’s a minimally invasive surgery designed for effective treatment.

Pre-Operative Preparation

Before EVAR surgery, patients go through tests and evaluations. These include CT scans or MRI to check the aneurysm’s size and location.

They also get advice on what to do before surgery. This includes stopping certain medications and fasting. They also learn about post-operative care at home.

During the EVAR Surgery

The surgery starts with small incisions in the groin. A catheter is then guided to the aortic aneurysm under imaging.

A stent-graft is deployed to block blood flow to the aneurysm. The procedure can be done under local or general anesthesia, depending on the patient’s needs.

Immediate Post-Operative Care

After surgery, patients are watched in a recovery area. They are then moved to a hospital room for more observation.

They are monitored for complications, pain managed, and given care instructions. Patients usually go home a few days later, depending on their recovery.

Stage	Description	Key Activities
Pre-Operative	Preparation before surgery	Imaging tests, medication adjustment, fasting
During Surgery	EVAR procedure execution	Catheter insertion, stent-graft deployment
Post-Operative	Care after surgery	Monitoring, pain management, discharge planning

Knowing the EVAR procedure helps patients prepare. It reduces anxiety and improves outcomes.

Medical Terminology in EVAR Explained

It’s important for patients to understand EVAR surgery terms. This knowledge helps them make better treatment choices. We’ll explain the main terms and abbreviations you’ll see.

Common EVAR Medical Abbreviations

EVAR has many confusing medical abbreviations. Let’s clear up some common ones:

• EVAR: Endovascular Aneurysm Repair
• AAA: Abdominal Aortic Aneurysm
• CT: Computed Tomography, a diagnostic imaging technique often used in EVAR
• Stent-Graft: A device used in EVAR to repair the aneurysm

Knowing these abbreviations is key for talking with your doctors.

Technical Terms Related to Aneurysms

Aneurysms are a big part of EVAR surgery. Here are some important terms:

• Aneurysm: A bulge or dilation in a blood vessel, which can be life-threatening if it ruptures.
• Aorta: The main artery that carries blood from the heart to the rest of the body.
• Endoleak: A complication of EVAR where blood leaks into the aneurysm sac.
• Stent: A small, mesh-like device that keeps the artery open.

Knowing these terms helps you understand your condition and treatment.

Procedural Terminology You Should Know

The EVAR procedure has several important steps and terms:

• Endovascular: Referring to procedures that are performed inside the blood vessels.
• Angiography: A diagnostic technique used to visualize the inside of blood vessels.
• Catheter: A thin, flexible tube used to deliver devices or contrast agents into the blood vessels.
• Graft: A device used to bypass or repair a diseased segment of a blood vessel.

Benefits of EVAR Vascular Surgery

EVAR surgery is great because it cuts down on recovery time and lowers the chance of complications. This makes it a good choice for those who can have it.

Reduced Recovery Time

One big advantage of EVAR surgery is how it shortens downtime. Unlike open surgery, which needs a big cut and can keep you in the hospital longer, EVAR uses small cuts in the groin.

This means patients feel less pain and can get back to their daily life sooner. Studies show EVAR patients stay in the hospital much less than those who have open repair.

“The minimally invasive nature of EVAR surgery allows patients to recover faster and return to their daily lives with minimal disruption.”

D Vascular Surgeon

Lower Complication Rates

EVAR surgery has fewer complications than open surgery. This is because it’s less invasive, causing less damage to tissues and fewer problems after surgery.

Complication	EVAR Surgery	Open Surgery
Infection Rate	2%	5%
Bleeding Complications	1.5%	4%
Cardiac Issues	3%	6%

Minimally Invasive Advantages

The minimally invasive approach of EVAR surgery is a big plus. It avoids the need for a big cut in the belly, reducing risks and helping healing.

Also, advanced imaging during the surgery lets doctors place the stent-graft exactly right. This makes EVAR safer and more effective.

In summary, EVAR vascular surgery offers many benefits. It reduces recovery time, lowers the risk of complications, and is minimally invasive. These make it a top choice for many patients.

Potential Risks and Complications

EVAR surgery is a big step in treating abdominal aortic aneurysms. But, it’s important to know the risks and complications. Every medical procedure has its own challenges that can affect how well a patient does.

Short-Term Complications

Right after EVAR surgery, patients might face several issues. These problems usually happen during or right after the surgery. Some common ones are:

• Endoleak: A condition where blood leaks back into the aneurysm sac.
• Stent migration: When the stent-graft moves from its original position.
• Kidney injury: Possible damage to the kidneys because of the procedure.
• Bleeding or hematoma at the access site.

A study in the Journal of Vascular Surgery found that endoleak after EVAR happens in 10% to 20% of cases. Handling these issues often means watching closely and sometimes needing more treatments.

Complication	Description	Typical Management
Endoleak	Blood leaks into the aneurysm sac	Monitoring, possible reintervention
Stent Migration	Stent-graft moves from original position	Additional stenting or open surgery
Kidney Injury	Damage to the kidneys	Supportive care, dialysis if necessary

Long-Term Considerations

After EVAR surgery, patients need to keep an eye on long-term issues. These can include:

• Stent-graft durability issues.
• Late endoleaks.
• Aneurysm sac enlargement.
• Device migration or failure.

A vascular surgeon, says, “Long-term checks are key after EVAR to spot and handle problems early.”

“The goal of long-term follow-up is to identify issues early, ensuring timely intervention and maintaining the health of the patient.”

Regular imaging studies are vital to watch the stent-graft and the aneurysm sac for any changes or problems.

Knowing the risks of EVAR surgery helps patients get ready for the procedure and recovery. It’s critical for doctors to talk about these risks with patients. This way, patients can make informed choices.

Stent-Graft Devices Used in EVAR

Stent-grafts are special devices used in EVAR to block blood flow to the aneurysm. This stops it from getting bigger and bursting. These devices are key to the EVAR success, giving a less invasive option for those with abdominal aortic aneurysms.

Types of Stent-Grafts

There are many stent-grafts for EVAR, each with its own benefits.

• Zenith Flex: Known for its flexibility and precision in deployment.
• Excluder: Designed to provide a secure and durable seal.
• Endurant: Offers advanced navigability and conformability.

These stent-grafts differ in design, material, and how they’re deployed. This lets doctors pick the best one for each patient’s needs.

How Stent-Grafts Function

Stent-grafts work by being placed in the aorta to block the aneurysm from blood flow. This is done through a small incision in the femoral arteries.

1. The stent-graft is compressed and loaded into a delivery system.
2. Under imaging guidance, the delivery system is navigated to the target location.
3. The stent-graft is deployed, expanding to fit snugly against the aortic walls, both above and below the aneurysm.

After deployment, the stent-graft allows blood to flow, bypassing the aneurysm. This reduces pressure on the weak aortic wall and lowers the risk of rupture.

Candidacy for EVAR: Who Qualifies?

To decide if someone is right for Endovascular Aneurysm Repair (EVAR), we look at many things. We check the body’s shape and health to see if EVAR is a good choice.

Anatomical Requirements

The shape of the aorta is key in deciding if EVAR is right. Specific anatomical requirements include:

• The size and shape of the aortic aneurysm
• The presence of suitable landing zones for the stent-graft
• Adequate access vessels for the delivery of the stent-graft

We use CT angiography to check these details closely. Here’s a table with important anatomical points:

Anatomical Factor	Ideal Characteristics
Aneurysm Size	Typically greater than 5.5 cm in diameter
Landing Zones	Sufficient length and diameter for stent-graft fixation
Access Vessels	Adequate diameter and minimal calcification or tortuosity

Health Considerations and Contraindications

A patient’s health is also very important for EVAR. We look at health conditions that might affect the outcome or recovery.

Some health factors include:

• Cardiac function and history of cardiovascular disease
• Renal function, specially in those with chronic kidney disease
• Presence of other serious medical conditions that may impact recovery

Things that might make EVAR too risky include severe kidney disease, big allergies to contrast agents, or other serious health issues. We check each patient’s health history for these risks.

Recovery and Life After EVAR Surgery

Knowing how to recover after EVAR surgery is key for patients. The recovery process includes time in the hospital, care at home, and ongoing check-ups. Each part is important for a smooth recovery.

Hospital Stay Expectations

Patients usually stay in the hospital for a few days after EVAR surgery. Medical staff watch over them, manage pain, and look for any issues. A leading vascular surgeon says, “The hospital stay is vital for a good recovery.”

The time in the hospital can change based on the patient. But most leave in 2-3 days. It’s important to follow the hospital’s advice for a smooth move to home care.

At-Home Recovery Guidelines

At home, patients must watch their health closely. Important steps include:

• Resting well and avoiding hard work
• Eating healthy to help healing
• Watching the surgical area for infection signs
• Taking medicines as the doctor says

One patient shared, “

Recovery at home needs patience and careful attention, but with the right help, it’s doable

.”

Long-Term Follow-Up and Quality of Life

Long-term check-ups are key to make sure the stent-graft works right. Tests like CT scans are used to check the aneurysm and the stent-graft.

Keeping a healthy lifestyle is key for long-term success. This means regular exercise, eating well, and not smoking. Most patients can get back to normal in a few weeks and see their life improve after EVAR.

Doctors say, “with the right care and follow-up, patients can see a big boost in their quality of life after EVAR surgery.”

Questions to Ask Your Doctor About EVAR

Getting ready for EVAR surgery? It’s smart to ask your doctor lots of questions. This way, you’ll know what to expect. Talking openly with your doctor is key to feeling comfortable and informed.

Before the Procedure

Before EVAR surgery, ask your doctor some important questions. This ensures you’re a good fit for the procedure and understand it well.

• What are the benefits and risks of EVAR surgery for my condition?
• How does EVAR compare to open surgery in terms of recovery and risks?
• What are the anatomical requirements for EVAR, and how will my body affect it?
• Are there any health issues that might make me not eligible for EVAR?
• Can I see the details of the EVAR procedure with my doctor, like the stent-graft type?

About Recovery and Long-Term Care

Knowing what to expect during and after EVAR surgery is important. It helps you plan for the best recovery and long-term care.

Aspect of Care	Questions to Ask
Hospital Stay	How long will I stay in the hospital after EVAR surgery?
At-Home Recovery	What should I do at home for recovery, like activity levels and meds?
Long-Term Follow-Up	What follow-up care will I need after EVAR, like tests and check-ups?

By asking these questions, you’ll understand EVAR better. This knowledge helps you make the best choices for your treatment.

Conclusion

EVAR surgery has changed how we treat abdominal aortic aneurysms (AAA). It’s safer and less invasive than old methods. We’ve talked about how it cuts down recovery time and lowers risks.

The EVAR procedure shows how far medical tech and surgeon skills have come. Knowing the terms helps patients understand their options better.

EVAR surgery is a big step forward in treating AAA. We’ve covered how it works, its good points, and possible downsides. Clearly, it boosts patient results and life quality.

If you’re thinking about EVAR surgery, talk to a doctor about if you’re a good candidate. Discussing risks and what to expect helps you make a smart choice. This way, you can use the newest in vascular surgery to your advantage.

FAQ

References:

• Yei, K., et al. (2022). Long-term outcomes of open versus endovascular abdominal aortic aneurysm repair. JAMA Network Open, 5(5), e222922. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2792290