Endovascular Repair (EVAR)

Endovascular Aneurysm Repair (EVAR) is a minimally invasive procedure used to treat an abdominal aortic aneurysm (AAA). This is a condition where the main artery (aorta) becomes enlarged and at risk of rupture. EVAR repairs the weak section of the artery without the need for open surgery.

It uses a stent graft, placed inside the artery, to support and seal off the aneurysm.

When Is EVAR Recommended?

The aneurysm is 5.5 cm or larger
There is rapid aneurysm growth
The aneurysm is leaking or at risk of rupture
The patient is unfit for open surgery due to age or health conditions

Early detection and treatment are key to preventing life-threatening rupture.

How the EVAR Procedure Works

Access Point: A small incision is made in the groin to reach the femoral artery.
Catheter Insertion: A catheter is guided through the artery to the aneurysm site.
Stent Graft Delivery: The stent graft (a metal mesh tube covered with fabric) is inserted and positioned precisely.
Sealing the Aneurysm: Once deployed, the graft reinforces the artery wall and reroutes blood flow through the graft.
Completion: Blood is now directed through the graft, reducing pressure on the aneurysm.

The procedure is guided by real-time X-ray imaging.

Benefits of EVAR Over Open Surgery

Minimally invasive (no large abdominal incision)
Shorter hospital stay (1–2 days)
Faster recovery time (within 1–2 weeks)
Less blood loss and pain
Reduced risk of infection and complications

EVAR is especially suitable for older adults or high-risk patients.

Risks and Limitations of EVAR

Although EVAR is highly effective, some risks include:

Bleeding or infection at the puncture site
Endoleak (blood leaking into the aneurysm sac)
Graft movement or blockage
Kidney damage from contrast dye
Need for future procedures or monitoring

Regular imaging follow-up (CT scan or ultrasound) is essential after EVAR to check for complications.

Who Is a Candidate for EVAR?

Have suitable aneurysm anatomy
Are at increased risk from open surgery
Need a quicker return to daily life
Prefer a less invasive treatment option

Patients with irregular artery shapes or very small vessels may not be eligible.

Post-EVAR Recovery and Care

Bed rest for a few hours after the procedure
Resume light activity in 2–3 days
Avoid heavy lifting for a few weeks
Routine imaging at 1 month, 6 months, and annually
Medication to manage blood pressure and cholesterol

Follow-up is critical for long-term success.