Endovascular aneurysm repair (EVAR) is a minimally invasive procedure used to treat aneurysms in the aortic arch and descending thoracic aorta. Also known as an endovascular stent graft, the EVAR procedure uses a stent graft, or endograft, to repair the aneurysm. 

EVAR Procedure

  • A collapsed, large caliber stent that has fabric on the outside (known as an endograft) is passed over a guide wire through a groin artery.
  • The device is positioned so each end will land in relatively normal sized aorta, and the middle part will span the aneurysm itself.
  • When the stent graft is expanded, the device seals itself to the normal sized aorta bordering the aneurysm.
  • Blood then flows through the stent graft, but the graft does not allow any flowing blood to be in contact with, or to pressurize the aneurysm itself.
  • Over time, these aneurysms can shrink around the endograft.

EVAR Benefits

  • Avoids the need for a large chest incision
  • Minimal interruption of blood flow to the lower body during the procedure
  • Many patients are able go home by the 2nd day after the procedure
  • Decreases the risk of paraplegia due to spinal cord blood flow interruption that is intrinsic to traditional descending thoracic aneurysm open surgery

Why Choose Valley for EVAR?

  • Aortic arch aneurysm repair: For aortic arch aneurysms, Valley uses a hybrid approach in which the aortic arch is “de-branched” by sewing bypass grafts to the aortic arch blood vessels. An endograft is then used  to span the arch aneurysm. This approach has dramatically lowered the morbidity and risk of total arch replacement.
  • Management of thoracic aortic aneurysms: Valley’s Thoracic Aneurysm Program offers surveillance and management of thoracic aortic aneurysms, including well-defined thoracic aortic aneurysm risk guidelines.
  • Decreasing risks during surgery: Our team focuses on maintaining patient safety throughout these complex procedures. For example, when patients have a higher risk for paraplegia, such as because of previous abdominal aortic surgery at a separate site, we use protective maneuvers to avoid this devastating complication, with positive outcomes thus far.
  • Treatment for thoracoabdominal aneurysms: Thoracoabdominal aneurysms are particularly tricky to treat because they span the diaphragm and involve an aortic segment where the arteries that supply our abdominal organs and kidneys originate. Thoracoabdominal aneurysms can potentially be “de-branched” and an endograft used to complete repair without having to directly handle the aneurysm itself. Though experience with this approach is limited worldwide, at Valley, we have begun treating thoracoabdominal aneurysms with this approach.
  • Custom fenestrated aortic aneurysm stent grafts: Vascular surgeons at Valley have implanted more fenestrated aortic aneurysm stent grafts for patients with complex abdominal aortic aneurysms than any other hospital in Bergen County. The team uses custom-made grafts that are designed to fit each patient individually. The procedure significantly reduces recovery time and lowers risk of complications. It is ideal for patients whose aneurysms cannot be repaired using traditional techniques.