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Endovascular Aortic Repair (EVAR)

Minimally invasive endovascular repair in abdominal aortic aneurysm.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Kardiyoloji department. Book Appointment →

What is Endovascular Aortic Repair (EVAR)?

Endovascular aortic repair (EVAR) is a minimally invasive treatment for infrarenal abdominal aortic aneurysm performed by transfemoral access. The aneurysm sac is excluded from circulation by deploying a stent-graft, halting expansion.

Patient suitability is determined by anatomical criteria (proximal neck length, angulation, iliac access vessel diameter). Compared to open surgery, EVAR has lower perioperative mortality (1% vs 3%) but requires lifelong endoleak follow-up. Total mortality is similar at 5-year follow-up.

Symptoms

Asymptomatic AAA (incidental finding)
Pulsatile abdominal mass
Lower back/abdominal pain
Distal embolisation findings
Acute rupture (haemodynamic instability)
Constitutional symptoms (in inflammatory aneurysm)

Risk Factors

Maximum aneurysm diameter >5.5 cm (men) or >5 cm (women)
Aneurysm growth rate >1 cm/year
Symptomatic AAA
Saccular aneurysm
Family history
Marfan/Ehlers-Danlos syndrome (EVAR contraindicated)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Newly diagnosed AAA evaluation
  • Threshold dimension reached in follow-up
  • Symptomatic AAA - emergency
  • Acute rupture suspicion - 112 - life threat
  • Anatomical suitability assessment for EVAR

Treatment Methods

01
CT angiography (preoperative planning)
02
Stent-graft sizing (proximal neck + distal landing zone)
03
Bilateral femoral access (percutaneous or cut-down)
04
Aortouni-iliac/bifurcated stent-graft deployment
05
Endoleak surveillance (CT angiography at 1 month, 6 months, then yearly)
06
Type I endoleak: emergency intervention (proximal/distal seal)
07
Type II endoleak: follow-up (rarely intervention)
08
Lifelong imaging follow-up
09
Open conversion (in failed EVAR)
10
Patient counselling (lifelong follow-up requirement)

Which Department to Visit?

You can visit our Kardiyoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Let us help you

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.