Endovascular aneurysm repair (EVAR) is a relatively new procedure that can treat disease and damage to the arteries with minimally invasive, non-surgical placement of expandable stent grafts within the aorta. EVAR can treat aortic disease without the need to operate directly on the aorta.
Generally, needles and sheaths are used to directly access the areas that need attention. The procedure is also sometimes referred to endovascular stent grafting. Endovascular stent grafting uses an endovascular stent graft to reinforce the wall of the aorta and to help keep the damaged area from rupturing.
In this article, we are going to take a dive into the topic of EVAR and go over many of the details. Including the inherent benefits of the procedure when compared with more traditional aortic surgeries.
Different arteries treated by EVAR
Under the umbrella of EVAR, there are different forms of an aneurysm that can be treated. As time goes on, new medical devices and techniques are being developed to help make endovascular procedures more commonplace.
Abdominal Endovascular Aneurysm Repair
EVAR’s most commonly treated ailment is the abdominal aortic aneurysm (AAA). Actually, in 2003, EVAR officially became the most common treatment option for repairs of the abdominal aortic aneurysm. That was the first time EVAR was ever considered the most common treatment option for any kind of vein disease.
Aneurysms like AAA that begin below the renal arteries are much easier to perform. These areas offer an adequate length of the aorta for the endograft to be attached to without any leakage of blood around the device to interfere. This kind of leak is referred to as an “endoleak.”
Branched Arch Aneurysm Repair
Aneurysms that occur along the arch of the aorta are the most difficult to treat and result in the most complications. This is largely because these arterial branches are responsible for blood supply to the brain as well as the upper extremities.
There is special equipment that is used to provide blood flow to many different organs all at once. This multi-branched stent graft is not fully available for doctors to use in the United States. There are only select centers that can offer this kind of repair. Getting in touch with your doctor of choice is the best way to know for sure if they offer this treatment.
Thoracic Endovascular Aneurysm Repair
The standard method for repairing this type of artery issue is an open-chest aneurysm repair, but minimally invasive aortic procedures are becoming more and more common over time.
Thoracic aortic aneurysms occur along the aorta just above the diaphragm area. The diaphragm is the partition between the chest and the abdomen. This includes the ascending aorta, the aortic arch, and the descending thoracic aorta.
Vascular vs Endovascular Surgeries
Vascular surgery and endovascular surgery are both used to treat vascular diseases. Every disease that endovascular surgery can treat is also treatable through traditional vascular surgeries. The difference is in the way the aorta is accessed by doctors.
Endovascular describes a minimally invasive option where small needles and stents are used to inject medicine directly into the vein or keep its integrity strong, respectively. Endovascular surgery is non-surgical in nature and minimally invasive, requiring just a small hole for the apparatus to enter the body.
Non-endovascular surgery is more invasive, usually requiring the skin to be broken by means of incision for direct access to the veins that need treatment. Vascular surgery is more surgical in nature.
Benefits of EVAR
The benefits of a non-surgical procedure, when compared to something surgical, are always relatively the same. There is a decrease in the amount of time needed for recovery. Aside from that, there is typically a lesser risk of infection and a shorter period of time needed for the procedure to be completed.
The one disadvantage of EVAR is that not all doctors provide it. More common forms of the procedure like those used to treat abdominal issues are easier to obtain, but the more complicated types are harder to find. A bit of research may be in order to find a provider who offers what you need in your area.
If you ever have questions or concerns about EVAR, you can get in touch with us at the Vein Institute of Utah. We are always happy to talk to our community and answer questions.