Endovascular Aneurysm Repair of Abdominal Aorta
Medically reviewed by Drugs.com. Last updated on Dec 2, 2022.
What do I need to know about endovascular aneurysm repair (EVAR)?
EVAR is a procedure to repair an abdominal aortic aneurysm (AAA).
How do I prepare for EVAR?
- You may need blood tests, an ultrasound, or a CT angiography scan before your procedure. These tests will help your healthcare provider plan for your procedure. Talk to your healthcare provider about these or other tests you may need. You will need someone to drive you home and stay with you after your procedure.
- Your healthcare provider will talk to you about how to prepare for your procedure. He or she may tell you not to eat or drink anything after midnight on the day of your procedure. The provider will tell you what medicines to take or not take on the day of your procedure. You may need to stop taking your blood thinner several days before your procedure.
- You may be given an antibiotic and contrast liquid during your procedure. Tell a healthcare provider if you have ever had an allergic reaction to antibiotics or contrast liquid.
What will happen during EVAR?
- You may be given general anesthesia to keep you asleep and free from pain during your procedure. You may instead be given IV sedation to make you feel calm and relaxed during the procedure. You may also be given local anesthesia to numb the procedure area. With local anesthesia, you may still feel pressure or pushing, but you should not feel any pain.
- Your healthcare provider will insert a catheter and wire into a blood vessel in each groin. He or she will move a wire through each catheter and up into your abdominal aorta. Your healthcare provider may inject contrast liquid so he or she can see your blood vessels more clearly on x-ray.
- Your healthcare provider will insert a graft inside of the aneurysm. A graft is a long tube that is covered by metal mesh. The mesh has hooks that help hold the graft in your abdominal aorta. The graft will prevent blood flow to the aneurysm. Instead, blood will flow through the graft. This will decrease pressure on the aneurysm. It will also decrease the risk of aneurysm rupture.
- Your healthcare provider will remove the catheter. Clamps, stitches, or other devices will be used to close your wounds. Pressure will be applied to each wound for several minutes to stop any bleeding. A pressure bandage or other pressure device may be placed over each wound. This will help prevent more bleeding.
What will happen after EVAR?
- You will be attached to a heart monitor until you are fully awake. A heart monitor is an EKG that stays on continuously to record your heart's electrical activity. Healthcare providers will monitor your vital signs and pulses in your legs. They will frequently check your pressure bandages for bleeding or swelling. You may have a Foley catheter. A Foley catheter is a tube that is inserted into your bladder. The tube drains your urine. It is usually removed a few hours after your procedure.
- You will need to lie flat with your legs straight for 2 to 4 hours. Do not get out of bed until your healthcare provider says it is okay. Leg movements can cause serious bleeding. You will spend 1 to 2 days in the hospital. You may have pain and bruising where the catheters were placed.
What are the risks of EVAR?
- You will need ongoing tests to check the graft position and size of your aneurysm. The graft may move out of place or leak blood into your aneurysm. A blood clot may block the graft and decrease blood flow through your abdominal aorta. You may need more than 1 EVAR.
- You may bleed more than expected or get an infection. You may need surgery to repair damage to your blood vessels from the catheter. You may also need surgery to stop bleeding. You may get a blood clot in your leg. The graft or catheter may stop blood flow to your legs. The contrast liquid may cause kidney damage or an allergic reaction. Even with EVAR, your aneurysm may rupture and cause life-threatening bleeding.
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