Endovascular Aneurysm Repair (EVAR)


The aorta is the largest artery in the body which carries blood around the body.  An endovascular aneurysm repair (EVAR) is a minimally invasive procedure which is performed as an alternative to invasive surgery, to treat a thoracic or abdominal aortic aneurysm (AAA). 

The wall of the artery may become weak due to the pressure of the blood pumping through. The weakening and the bulging of this artery is called an aortic aneurysm.

Before the procedure

Fasting: Do not to eat or drink 6-12 hours before the procedure, since your procedure will be under general anaesthesia.

Allergies: Please inform Intra staff at the time of booking if you have any food or medication , or previous reactions to X-ray contrast (dye).

Diabetes: If you are diabetic, please tell Intra staff at the time of booking. You may need to discuss your insulin/diabetes medication doses with your doctor.

Anticoagulation (blood thinners):  If you are taking any blood thinners (e.g Warfarin, Clexane, Pradaxa, Rivaroxaban), please make this known to Intra staff at the time of booking. You will need to stop this medication temporarily 2-5 days before the procedre, but this will be advised.

Other usual medications: Please inform your doctor of all the medications you are taking. Your doctor may advise you to stop taking some of these temporarily a few days prior to the procedure.

During the procedure

This procedure is non-invasive,  being performed entirely through a small access in an artery of both of groins. This is performed under a general anaesthetic; however local anaesthetic is also injected around the access sites.

Using contrast dye and fluoroscopy stent-graft is inserted through the femoral artery and advanced up to the site of the aortic aneurysm. This process is usually repeated using more grafts, depending on your anatomy.

Once  the graft(s) are in the optimal position, they are opened and expanded, covering the aneurysm, and ensuring there is full coverage above and below the aneurysm. This will prevent blood flowing into the aneurysm.

An EVAR is performed by an interventional radiologist and vascular surgeon, assisted by nurses and other highly skilled staff. This can take up to two hours to complete.

The benefit of the endovascular approach is reduced recovery time, particularly as there are no large incisions that need to heal. 

After the procedure.

  • After the procedure you will be taken to the recovery unit where you will be monitored until you wake up fully. Then you will be taken back to the ward.
  • Unless you have required a surgical cut down to one or both groins, you will be able to sit up as soon as you are fully awake.  
  • Depending on the procedure, most patients are often discharged the next day. Once discharged most patients return to normal activity within 2 weeks or less.

What are the risks?

As with any procedure, there are potential risks involved. Your interventional radiologist will explain the procedure, discuss possible risks and answer any questions you may have. You will then be asked to sign the consent form. This will occur on the day of your procedure.