EVAR involves inserting a stent-graft within the aneurysm through the groin arteries using X-ray guidance to position it correctly. The diagram above shows the steps involved in inserting the device. The advantage of this type of repair is that there is no abdominal surgery. This technique is therefore safer than the traditional operation, and you need to spend less time in hospital. A disadvantage is that some patients have to undergo a further operation at a later stage to refine the initial procedure.
Not every patient or every aneurysm is suitable for this. In particular, aneurysms arising close to or above the kidneys are more difficult to treat in this way. You will be assessed with a scan to determine if your aneurysm can be treated by endovascular repair. If suitable you will be offered a choice of type of repair by your surgeon. If this cannot be undertaken at your local hospital, you may need to travel to a centre that can perform endovascular repair.
Complications: The risk of a major complication is lower for endovascular repair, as the operation does not interfere with the circulation as much as open surgery. However, the graft attachment is not as secure as in the open operation. As a result, you may need follow up with scans to ensure that the graft has not moved. It is estimated that about 1 in 10 patients may need a further intervention or operation on their stent-graft. Most of these are again, small procedures with further stents.
Recovery: After uncomplicated endovascular repair, most patients return to the hospital ward for one to two days. You should be able to eat and drink normally once fully awake following your aneurysm repair.
Once you are up and about, you should be able to leave hospital, but may need painkilling tablets for up to a week. Discussions with patients who have undergone endovascular repair suggest that it is normal to make a full recovery in about 2 weeks. During this time, you should gradually build up your level of activity back to normal. You may resume normal sexual relations as soon as you as you feel comfortable.
Return to work: Most people who are treated with endovascular repair can return to work within a month after having surgery.
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