This is a minimally invasive procedure in the treatment of aneurysmal dilatation of the abdominal aorta. The procedure is performed under general, epidural or local anesthesia by accessing the dilatation through both arteries in the inguinal region of the patient. Special catheters are used under the X-ray control in the angio room to insert a covered stent, i.e. stent graft at dilatation segment. This prevents the aorta from rupturing and over time reduces the width of the aorta in that segment. At the end of the procedure, the access point is surgically closed or a special type of artery closure device is used in such procedures. A large number of anatomical criteria must be met so that a patient could be considered eligible for the EVAR procedure. The eligibility is verified by previously performed CT examination of the aorta and arteries of the legs. There are other types of these stents, stent grafts with lateral openings, as well as with lateral branches that allow patency of arteries starting from the abdominal aorta, which increases the number of patients who are eligible for endovascular treatment. Sometimes it is necessary to perform previous surgery on the inguinal arteries in order to provide an access point and ensure proper placement of the stent graft. These are the so-called hybrid procedures and can be performed during the same or separate hospitalization of the patient.
Author: Vladimimr Kovačević, Radiologist