Abdominal Aortic Aneurysm Repairs (AAA)

The Endovascular Aneurysm Repair (or EVAR) is a minimally-invasive procedure used to repair an Abdominal Aortic Aneurysm (AAA).

An AAA is a weakening or bulging of the walls of the abdominal aorta, the largest artery in the body and the body’s main supplier of blood. When an AAA grows too large, it may spontaneously rupture, leading to internal bleeding, shock and possibly death. Open surgery or EVAR to repair an AAA is usually indicated when the AAA reaches 5.5 cm or greater.

In contrast to open surgical repair of an AAA, EVAR involves the placement of an expandable stent graft within the aorta to exclude the AAA—without surgery. Very small incisions are made in both groins to access the femoral arteries. Vascular sheaths are then introduced into the femoral arteries through which guide wires, catheters, and the endograft are passed. In the past five years, EVAR has accounted for the majority of AAA repairs in the country.

The newest evolution in EVAR is a fully-Percutaneous EVAR (PEVAR), which is an even more minimally invasive technique.

Instead of incisions in the groins, small punctures are made directly through the skin into the femoral arteries. Vascular sheaths are then advanced over small wires into the femoral arteries, through which the catheters and stent graft devices are advanced.

Each of the procedures for AAA repair has differing criteria and risks. Your physician will fully discuss which of these various options is most appropriate for you when planning your AAA repair. In most cases, patients with either EVAR or PEVAR will enjoy a much quicker procedure recovery time and return to normal activities.

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