What Is Aortic Aneurysm Repair?
Aortic aneurysm repair prevents rupture by excluding or replacing the weakened segment. Endovascular aneurysm repair, or EVAR, places a stent graft through arteries in the groin. Open repair replaces the diseased aorta through a larger operation. EVAR generally involves smaller incisions and faster early recovery, while open repair may offer advantages for selected anatomy and requires a different long-term surveillance pathway.
Who May Be Considered?
- An aneurysm that has reached an appropriate repair threshold
- Rapid growth or symptoms attributable to the aneurysm
- Anatomy suitable for a durable endovascular or open repair
- Overall health and life expectancy that support preventive treatment
Assessment and Tests
- Thin-slice CT angiography and measurement review
- Comparison with earlier scans for growth
- Heart, lung, kidney and functional assessment
- Discussion of EVAR anatomy, open repair and surveillance
How Treatment May Be Performed
EVAR advances a stent graft through groin arteries to seal the aneurysm
Open repair clamps the aorta and replaces the weak segment with a graft
Blood flow to branch arteries is protected according to aneurysm location
Post-repair imaging checks the graft and aneurysm sac
How to Prepare
Bring every prior aneurysm scan so growth can be confirmed. Stop tobacco, optimise blood pressure and follow individual instructions for antiplatelets, anticoagulants, diabetes medicines, fasting and kidney protection. Dental, skin or urinary infections should be reported.
Comfort and Anaesthesia Planning
Open repair requires major anaesthesia and intensive perioperative planning. EVAR may use general, regional or local techniques depending on anatomy, device and patient health.
What to Expect During Recovery
EVAR often has a shorter initial recovery than open repair, but both require activity, wound and medicine instructions. Open recovery commonly takes several weeks. Exact timing depends on aneurysm complexity and health before surgery.
Risks and Limitations
Both approaches carry risks of bleeding, heart or lung complications, kidney injury, bowel or limb circulation problems, infection and death. EVAR can develop endoleak, device movement or later reintervention; open repair has greater early physiological stress.
Alternatives to Consider
Aneurysms below a repair threshold are commonly monitored with scheduled imaging while cardiovascular risks are treated. Repair may not offer net benefit when operative risk or limited life expectancy outweighs rupture prevention.
Follow-Up After Treatment
EVAR requires lifelong imaging to check the seal, device and aneurysm sac. Open repair also needs clinical follow-up and selective imaging. Sudden severe abdominal or back pain, fainting or collapse requires emergency care even after prior repair.
