How is endovascular repair (EVAR) performed for abdominal aortic aneurysm (AAA)?

Updated: Jan 08, 2019
  • Author: Saum A Rahimi, MD, FACS; Chief Editor: Vincent Lopez Rowe, MD  more...
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Answer

Endovascular repair of an AAA involves gaining access to the lumen of the abdominal aorta, usually via small incisions over the femoral vessels. An endograft, typically a polyester or Gore-Tex graft with a stent exoskeleton, is placed within the lumen of the AAA, extending distally into the iliac arteries. Several such grafts have been approved for use in the United States. [38]

The graft serves to contain aortic flow and decrease the pressure on the aortic wall, leading to a reduction in AAA size over time and a decrease in the risk of aortic rupture. Whereas EVAR repair has less operative morbidity than open repair does, it is more likely to necessitate secondary intervention, which increases cost. [25, 28, 29]


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