Endovascular aneurysm repair

EVAREndoleakThoracic Endovascular Aneurysm RepairThoracic endovascular aortic repairabdominal aortic aneurysmsendoluminal vascular repairendovascularEndovascular aortic aneurysm repairendovascular repairEndovascular repair of abdominal aortic aneurysm
Endovascular aneurysm repair, is a type of endovascular surgery used to treat pathology of the aorta, most commonly an abdominal aortic aneurysm (AAA).wikipedia
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Abdominal aortic aneurysm

abdominal aneurysmabdominal aortic aneurysmsabdominal
Endovascular aneurysm repair, is a type of endovascular surgery used to treat pathology of the aorta, most commonly an abdominal aortic aneurysm (AAA).
Repair may be either by open surgery or endovascular aneurysm repair (EVAR).

Open aortic surgery

aortic surgeryabdominal aortic aneurysm repairaneurysmectomy
In 2003, EVAR surpassed open aortic surgery as the most common technique for repair of AAA, and in 2010, EVAR accounted for 78% of all intact AAA repair in the United States.
In 2003, OAS was surpassed by endovascular aneurysm repair (EVAR) as the most common technique for repairing abdominal aortic aneurysms in the United States.

Stent

stentsstentingstent graft
The procedure involves the placement of an expandable stent graft within the aorta to treat aortic disease without operating directly on the aorta.

Aortic dissection

dissecting aortic aneurysmdissectionthoracic aortic dissection
Endografts have been used in patients with aortic dissection, noting the extremely complex nature of open surgical repair in these patients.
Surgery may be done either by an opening in the chest or from inside the blood vessel.

Vascular surgery

vascular surgeonvascularEndovascular surgery
Endovascular aneurysm repair, is a type of endovascular surgery used to treat pathology of the aorta, most commonly an abdominal aortic aneurysm (AAA). It is usually carried out by an vascular surgeon or cardiac surgeon, and occasionally, general surgeon or interventional cardiologist or radiologist.

Minimally invasive procedure

minimally invasiveminimally invasive surgerynon-invasive
Like many surgical procedures, EVAR has advanced to a more minimally invasive technique, by accessing the femoral arteries percutaneously In percutaneous EVAR (PEVAR), small, sub-centimeter incisions are made over the femoral artery, and endovascular techniques are used to place the device over a wire.
An endovascular aneurysm repair as an example of minimally invasive surgery is much less invasive in that it involves much smaller incisions than the corresponding open surgery procedure of open aortic surgery.

Aortic rupture

ruptured aortaruptureruptured aortic aneurysm
EVAR is also used for rupture of the abdominal and descending thoracic aorta, and in rare cases used to treat pathology of the ascending aorta.
If indicated, treatment with EVAR or open repair of the diseased aorta can limit the risk of aortic rupture.

Albert Einstein College of Medicine

Albert Einstein CollegeAlbert Einstein College of Medicine of Yeshiva UniversityEinstein College
Frank Veith, Michael Marin, Juan Parodi and Claudio Schonholz at Montefiore Medical Center affiliated with Albert Einstein College of Medicine.

Pathology

pathologistpathologicalpathologies
Endovascular aneurysm repair, is a type of endovascular surgery used to treat pathology of the aorta, most commonly an abdominal aortic aneurysm (AAA).

Aorta

aorticaortic archaortic root
Endovascular aneurysm repair, is a type of endovascular surgery used to treat pathology of the aorta, most commonly an abdominal aortic aneurysm (AAA). Standard EVAR is appropriate for aneurysms that begin below the renal arteries, where there exists an adequate length of normal aorta (the "proximal aortic neck") for reliable attachment of the endograft without leakage of blood around the device ("endoleak").

Descending thoracic aorta

thoracic aortathoracicthoracic part
When used to treat thoracic aortic disease, the procedure is then specifically termed TEVAR for "thoracic endovascular aortic/aneurysm repair."

Renal artery

renal arteriesrenalarteries of the kidneys
Standard EVAR is appropriate for aneurysms that begin below the renal arteries, where there exists an adequate length of normal aorta (the "proximal aortic neck") for reliable attachment of the endograft without leakage of blood around the device ("endoleak").

Embolism

embolicerebral embolismembolus
Repair is also warranted for aneurysms that rapidly enlarge or those that have been the source of emboli (debris from the aneurysm that dislodge and travel into other arteries).

Pain

physical painacute painnociceptive pain
Lastly, repair is also indicated for aneurysms that are the source of pain and tenderness, which may indicate impending rupture.

Tenderness (medicine)

tendernesstenderAbdominal tenderness
Lastly, repair is also indicated for aneurysms that are the source of pain and tenderness, which may indicate impending rupture.

Ascending aorta

aortic rootaorticaortic bulb
EVAR is also used for rupture of the abdominal and descending thoracic aorta, and in rare cases used to treat pathology of the ascending aorta.

Contraindication

contraindicatedcontraindicationscontraindicate
Other relative contraindications include prohibitively small iliac arteries, aneurysmal iliac arteries, prohibitively small femoral arteries, or circumferential calcification of the femoral or iliac arteries.

External iliac artery

external iliac arteriesexternalexternal iliac
Other relative contraindications include prohibitively small iliac arteries, aneurysmal iliac arteries, prohibitively small femoral arteries, or circumferential calcification of the femoral or iliac arteries.

Femoral artery

femoralfemoral arteriessuperficial femoral artery
Other relative contraindications include prohibitively small iliac arteries, aneurysmal iliac arteries, prohibitively small femoral arteries, or circumferential calcification of the femoral or iliac arteries.

Cardiothoracic surgery

cardiothoracic surgeonthoracic surgerycardiac surgeon
It is usually carried out by an vascular surgeon or cardiac surgeon, and occasionally, general surgeon or interventional cardiologist or radiologist.

General anaesthesia

general anesthesiageneralgeneral anesthetic
The procedure can be performed under general, regional (spinal or epidural) or even local anesthesia.

Local anesthesia

regional anesthesialocallocal anaesthesia
The procedure can be performed under general, regional (spinal or epidural) or even local anesthesia.

Percutaneous

percutaneously percutaneous stimulationPercutaneous endovascular
Like many surgical procedures, EVAR has advanced to a more minimally invasive technique, by accessing the femoral arteries percutaneously In percutaneous EVAR (PEVAR), small, sub-centimeter incisions are made over the femoral artery, and endovascular techniques are used to place the device over a wire. Access to the patient's femoral arteries can be with surgical incisions or percutaneously in the groin on both sides.

Internal iliac artery

internal iliac arterieshypogastric arteryiliac arteries
Alternatively, a specially designed endograft, (an iliac branch device) can be used to preserve flow to the internal iliac arteries.

Claudication

calf pain when walkingclaudication of the leg
The preservation of the hypogastric (internal iliac) arteries is important to prevent buttock claudication and impotence, and every effort should be made to preserve flow to at least one hypogastric artery.