Endovascular graft treatment of abdominal aortic aneurysms (AAA) requires precise imaging and careful planning. With current technology, over 95% of the AAA that we evaluate are repaired by EVAR. The stent-reinforced grafts are usually placed through the femoral arteries in the groin and positioned inside the aorta. The grafts are placed into the aorta below the arteries to the kidneys and into the arteries going to each leg. Most patients are sent to a regular hospital bed after surgery and go home the following day. A further subset of patients with aneurysms involving the renal arteries are able to be treated with fenestrated EVAR (fEVAR) in a technique available at only a handful of medical centers due to the complexity of the procedure.
The primary advantage of EVAR or fEVAR is a significantly shorter recovery after surgery with lower mortality, compared to standard open aneurysm repair. Most patients have minimal discomfort and are able to resume normal activity within 1-2 weeks. Follow-up CT scans are required for all patients for the remainder of their lives. 25-30% of patients will require some additional endovascular procedure to stop persistent flow of blood in-between the graft and the wall of the aorta, known as an endoleak.