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Enovascular abdominal aneurysm repair (EVAR)

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Dr Richard Gibbs

Enovascular abdominal aneurysm repair (EVAR)

Mr Gibbs - Vascular Consultant at Imperial College - explains minimally invasive treatment of AAA.

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What is an endoleak?

Mr Gibbs explains that an endoleak is the finding of blood flowing into the aneurysm around a stent graft (medical device) after it has been inserted in endovascular (keyhole) repair. This is one of the important complications to be aware of and can be found on scans during follow up. There are different types of endoleaks, some of which can lead to high pressure blood flow into the aneurysm, and these need procedures to prevent rupture (bursting).

What factors would predict a long term successful EVAR?

Mr Gibbs talks to Mr Jaffer about if we can predict whether EVAR (keyhole repair) is likely to be successful or not in which patients. It appears to be the key factor is poor or complex anatomy (configuration) of the aorta, which can lead to higher rates of leakage or slippage of the graft. This is important to consider with your clinician.

What is the length of the stay in hospital after aneurysm repair?

Mr Gibbs talks to Mr Jaffer about the importance of length of stay in hospital after aneurysm repair in deciding whether to opt for endovascular (keyhole) repair or open surgery. With endovascular repair, a lot of patients can expect to be in hospital for about one to two days. But for open repair, because this is a much larger operation, this would need at least one day in intensive care or high dependency units, and another few days in hospital. But it is important to weigh this up against the longer term outcomes of durability, which tend to favour open repair.

What is the need for follow up or further procedures after aneurysm repair?

Mr Gibbs discusses with Mr Jaffer that patients who have open repair usually require less follow up and may only need one or two follow up appointments with a scan to make sure there are no issues with the repair. But for endovascular (keyhole) repair, more regular follow up is needed, at least every year, because it tends to be less durable and can lead to complications, and these may require further procedures.

Open repair of aortic aneurysms

Mr Gibbs - Vascular Consultant at Imperial College - talks about open aortic aneurysm repair.

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