The procedure is minimal invasive and can be done purely with needle access through the skin or with small groin cuts to access the Femoral arteries. The aneurysm is repaired by inserting a device on the inside of the arteries to exclude the aneurysm from the circulation.
It can be performed either in the operating room or a dedicated interventional angiography suite. The device is inserted in two pieces: the main body from one groin artery and the separate leg from the other groin. A quality control X ray die test is performed to ensure a good seal at the end.
Sometimes additional procedures might be necessary, such as:
- internal iliac embolization (occlusion) if the distal landing zone is in the external iliac artery,
- conduit (additional tube-graft stitched to the native artery) if access vessels are too small,
- aorto-uni-iliac stent (stent with only one limb) if the other side is not accessible (example: occluded access vessel) and occlusion of the iliac vessels (iliac arteries originate from aorta within the lower abdomen) and to preserve blood flow to the lower limb femoro-femoral crossover graft is needed.
Patients who are treated with EVAR need life-long surveillance for possible graft related complications which may need further procedures to fix them.
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