Endovascular aortic repair (EVAR) is a method also known as closed or stent graft repair, where an artificial vessel, which is loaded on a catheter (thin plastic tube), is advanced and deployed to diseased segment of abdominal aorta through femoral artery.
For the EVAR procedure, the groin area is used as puncture site. For this purpose, open (small surgical incision) or closed (Seldinger technique, puncture with needle) technique is used. Next, wires used for the procedure, catheters (plastic tubules) and finally, the endograft (stent graft designed for EVAR) are deployed through these areas. Diagnostic angiography is very important to identify renal arteries and to place endograft below that level during the procedure. This stage of the procedure requires due care, since serious problems can be faced if renal arteries are occluded by endograft. After the deployment of endograft, sequential dilated aneurysmatic segments are endografted if the aneurysm (frequently) also involves iliac arteries. Repeated angiography is performed to check final picture at the end of the procedure. At this stage, we check success of the procedure, i.e. whether there is leakage from endograft into true aneurysm. After the deployment, interior part of the endograft serves like a native abdominal aorta. Pressure in lumen of the aneurysm decreases and this sac reduces over the time.