What are the risks of minimally invasive aneurysm repair EVAR?

what are the risks associated with minimally invasive aneurysm repair? So the the upfront risks of an endovascular approach for stenting are much less because you are not performing a major cavity operation so it's much less stress on the heart and the lungs, it can be done at the regional or local anaesthetic, it's either very small cut in the groin or even a percutaneous approach. So the recovery from that procedure is much faster and that is important in an elderly group with more comorbidities and also if you are in your late 80s, time is precious and what you don't want to be doing is having three months recovering from a procedure whereas you could recover in four or five days and literally the hospital stay is probably realistically, you know, overnight or two nights. Some people do them as a day case. Some of the problems with day case surgery, although it's possible physiologically, you do run into problems of trying to get elderly people home late in the evening without much support. So although it's doable, some of the other constraints of an elderly person going to hospital coming to play. The main issue longer term with endovascular approaches is how durable a seal is and if there is any leak back into the sac. So the aneurysm sac is left in situ and if you've got blood leaking back into that from an inadequate seal that can cause it to expand again and the aneurysm then becomes pressurized. Those are called endoleaks and some are worse than others, but it does then mandate constant surveillance, probably minimal is one scan a year, looking and dealing with endylics. And the big change or big difference between open surgery and endovascular is that the re-intervention rate for endovascular cases is much, much higher, so they need more looking after afterwards, albeit usually again minimally invasive.