Endovascular Aortic Aneurysm Repair (EVAR) or Thoracic Endovascular Aortic Aneurysm Repair (TEVAR)

Endovascular aortic aneurysm repair (EVAR) is a surgery used to treat an abdominal aortic aneurysm (AAA). For a patient with a thoracic aortic aneurysm (aneurysm in the chest area), the procedure is termed thoracic endovascular aortic aneurysm repair (TEVAR).


Endovascular is a term that refers to “inside the blood vessels.” An aneurysm is the bulging or ballooning of a weakened area of a blood vessel.

  • The wall of the aorta (the largest blood vessel in the body) can become weak due to age
  • High blood pressure
  • Disease
  • Trauma.

This may cause the aortic wall to bulge, leading to an aortic aneurysm. As the bulge grows, the wall of the aorta becomes weaker. This may cause the aorta to rupture and lead to massive internal bleeding.
A ruptured aneurysm requires immediate medical attention. In most cases, patients have no symptoms. However, for those patients with symptoms, the most common are pain in the abdomen, back, or chest.

  1. It is a fabric tube supported by metal wire mesh that reinforces the weak spot in the aorta.
  2. It expands and allows blood to pass through without putting pressure on the aneurysm.
  3. The stent graft makes a new path for the blood to flow through and remains inside the aorta permanently.
  1. It is generally less painful.
  2. It has a lower risk of complications than traditional surgery (open surgical repair) because the incisions are smaller.
  3. Endovascular repair procedures also allow you to leave the hospital sooner and recover more quickly.
In preparing for surgery your doctor will explain your heart condition, the reason for surgery, the risks associated with the procedure, and the pros and cons of the surgery. Furthermore, please note the following:
  1. It is recommended that patients visit their dentist to treat any problems with their teeth and gums as these can cause infection after the surgery. It is important that you tell your dentist that you have heart disease so they can prescribe antibiotics before and after the dental procedures.
  2. Avoid drinking alcohol and smoking cigarettes for at least one month before the surgery.
  3. If you have a history of bleeding easily or clotting problems, or if you or family members have ecchymoses (discolorations on the skin due to bleeding), please inform the doctor.
  4. Avoid certain medications for five to seven days, including anticoagulants and certain heart medication, as recommended by your doctor.
  5. Please inform your doctor about any drug allergies and/or other allergies you have.
Endovascular aortic aneurysm repair (EVAR) or thoracic endovascular aortic aneurysm repair (TEVAR) is performed by making two small incisions in the groin and threading two catheters through the patient’s arteries. The surgeon inserts a stent graft into the arteries through these incisions and positions it inside the aorta.
After the procedure, the patient may be required to lay flat for 4-6 hours. This will allow the leg wounds to start healing. Some mild discomfort may be felt at the wounds in the groin. Ask your health care team when you can shower, return to work, and resume other normal activities. Avoid strenuous activities and heavy lifting for about one month after surgery. The patient can expect to stay in the hospital for 3-5 days.
  • The possible complications of endovascular repair include:
  • Leaking of blood around the graft, known as endoleak
  • Stent fracturing
  • Blockage of the blood flow through the graft
  • Infection
  • Delayed aneurysm rupture
  • Renal failure (2%)
  • Deep vein thrombosis (DVT)
  • Blocked blood flow to the abdomen or lower body
  • Death
Open surgical repair involves making a large incision to remove the area where the aneurysm has damaged the aorta. The area is surgically separated from the aorta and replaced with a synthetic tube that is sewn into place. The surgery takes more time and results in a much longer hospital stay than endovascular aortic aneurysm repair (EVAR) or thoracic endovascular aortic aneurysm repair (TEVAR).

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