An abdominal aortic aneurysm (AAA) is a weakened bulge in the aorta, the body's largest artery. An AAA puts you at risk of a rupture in this large blood vessel. Penn Medicine offers every available aortic aneurysm treatment to provide your best chance for a healthy life.
Many people are eligible for endovascular repair of abdominal aneurysm (EVAR). This minimally invasive option can repair an aneurysm without an open incision. EVAR reduces the risks of open surgery and offers a wide range of methods to repair abdominal aortic aneurysms.
What Is Endovascular Aneurysm Repair (EVAR)?
With endovascular aneurysm repair (EVAR), surgeons can repair an aneurysm without an open incision. Increasingly, Penn surgeons can use this minimally invasive technique for many types of aneurysms. Compared to open surgery, EVAR has less pain, improved outcomes and faster healing.
Our team is the most experienced in the region and among the most experienced in the United States in all types of EVAR for:
What Happens During an EVAR Procedure?
A vascular surgeon performs EVAR. During the EVAR procedure:
- The vascular surgeon threads a catheter (a long, flexible tube) into a small puncture in your groin or arm.
- The surgeon then feeds the catheter through a blood vessel to the aneurysm.
- Using the catheter and tiny tools, the vascular surgeon places a fabric tube (endograft stent) inside the aneurysm. The stent is like a new pipe to reline the blown-out pipe of the aneurysm. It relieves pressure on the aneurysm and prevents it from rupturing.
After an endovascular abdominal aortic aneurysm repair, many people go home the next day. As you recover, you can return to your typical activities. You'll likely feel like yourself again within about three weeks.
Fenestrated Endovascular Aneurysm Repair (FEVAR)
FEVAR is a specialized type of EVAR. It treats abdominal aortic aneurysms located in the part of the aorta that carries blood to the kidneys. Fenestrations are small openings, like windows, in the EVAR graft. These windows let our surgeons repair the aneurysm while still allowing blood to flow to your kidneys.
Customized Endograft Repair
In some cases, an aneurysm affects areas of the aorta where there is not yet a stent graft approved by the U.S. Food and Drug Administration (FDA). To treat these cases, our team has access to newer devices that are only available through clinical trials.
In some cases, we can use custom-manufactured fenestrated stent grafts designed to fit your specific anatomy. Only about 10 institutions in the U.S. have access to this technology. We share information about the results through a research consortium. This option enables us to treat complex aneurysms that may not otherwise have a solution, while advancing aneurysm care for everyone.
Endovascular Repair of AAAs: The Penn Medicine Difference
Penn Medicine is redefining heart and vascular care at every state of disease, and we have extraordinary expertise in minimally invasive aneurysm repair. When you choose Penn for abdominal aortic aneurysm treatment, you'll find:
- Exceptional experience: Surgeons in Penn's Vascular Surgery and Endovascular Therapy Program and Aorta Center treat some of the most complex cases of aortic repair. Doctors all over the area send patients to us for advanced aortic surgery.
- Care for complex cases: AAAs can be extremely complex if they involve arteries that feed the abdominal organs. Penn vascular surgeons have access to advanced endovascular grafts not available everywhere. We are one of the few centers in the country with access to advanced aortic stent grafts through an investigational device exemption (IDE). When an appropriate graft isn't available, an IDE enables a clinical researcher to make safe decisions about when to use new types of grafts to repair an aneurysm.
- Excellent outcomes: As one of the leading centers for thoracic aortic, abdominal aortic and carotid stent grafting in the nation, Penn is among a handful of centers leading the movement toward endovascular surgery.
- Precise diagnosis: Knowing an abdominal aortic aneurysm's exact location and extent is vital to your care. We use advanced testing to evaluate your aneurysm and determine your treatment plan. Read more about vascular testing and diagnosis.
Open Surgery for Aneurysm Repair
For some people, open aneurysm repair may be a better choice than EVAR. Research has shown a clear connection between the number of surgeries a center does and patients' outcomes. At Penn, we perform a large number of open aneurysm repairs, so you can trust our expertise. Penn vascular surgeons work closely with our colleagues in the Aorta Center to determine which surgery is right for you.
An open aneurysm repair involves an incision in your abdomen or side so that surgeons can reach and repair the aneurysm. After the surgery, you will stay in the hospital for about a week. Your recovery at home may take six to 12 weeks.
Cardiac Rehabilitation After EVAR
Endovascular aortic repair is a minimally invasive procedure, but you may still benefit from cardiac rehabilitation to help regain your heart health. Penn's cardiac rehab is an outpatient program that includes exercise, nutrition, education and support.
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