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Endovascular Stent Grafting

Endovascular Stent Grafting: Find When you Need EVAR

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How will be the life after Endovascular stent grafting?
Can Endovascular stent grafting kill Aortic Aneurysm?

What is Endovascular Stent Grafting?

Endovascular stent grafting is also known as endovascular aneurysm repair (EVAR). It is a surgical procedure done inside of your aorta. It is a process of using a thin tube called a delivery catheter. It doesn’t involve a long cut in your abdomen but it requires only two small incisions in the area of your groin.

Physicians generally prefer endovascular stent grafting to treat abdominal aortic aneurysms (AAAs), rather than treating thoracic aortic aneurysms (TAAs) and less commonly, aneurysms in other locations.

Endovascular Stent Grafting

Endovascular aneurysm EVAR stent graft deployment sequence – endovascular surgery image credit: researchgate

Why is endovascular grafting performed?

Aortic Aneurysm treatment aims at reducing the risk of complications from aneurysms. The major risk for untreated aneurysms is rupture. As an aneurysm gets bigger, the risk also gets greater. There are several other factors to consider when deciding to treat an aneurysm with surgery. The following are some of the factors you need to consider before deciding the treatment option.

  • The presence of symptoms, including abdominal pain, back pain or pain in the groin or inner thigh.
  • The size of the aneurysm, in particular, its diameter
  • How fast the aneurysm is growing, in particular, rapid aneurysm growth (diameter grows more than 1 centimeter per year)
  • The development of an of an aortic dissection, which can be accompanied by sudden and severe sharp tearing pain in the chest or back
  • The patient’s overall medical condition

However, your doctor will discuss all the specific conditions and needs while choosing the best treatment option.

How the endovascular stent graft will be placed in the aortic aneurysm?

  • The catheter is inserted into an artery in the leg near the groin.
  • Delivery catheter is inserted through the vessel into the aneurysm to guide the stent into place.
  • Using advanced imaging methods, the surgeon guides the delivery catheter carrying the stent graft to the area of the abdominal aortic aneurysm.
  • Once the stent graft is in position, the surgeon fastens it into place and removes the delivery catheter.
  • The endovascular stent graft is placed inside the abdominal aorta to help keep the aneurysm from bursting.

What are the Risks involved in endovascular grafting?

Removal of part of the aorta is not carried out during Endovascular stent grafting. However, it involves the risk of aneurysm rupture which is slightly higher compared to open-surgery aneurysm repair.

Other complications associated with endovascular stent grafting include:

  • Blood leakages around the stent graft
  • Blockage of the flow of blood through the stent graft
  • Movement of the stent graft from its original site of placement
  • Fracture of the stent graft
  • Infection
  • Rupture of the aneurysm or aorta

To monitor the above-mentioned complication, your doctor will schedule the periodic visits after your surgery to make sure your stent is working correctly.

Follow Visits

Follow up visits will be scheduled by your doctor to check your overall health conditions and make sure that you are healing properly. As a part of Follow up visits, your doctor will schedule follow-up imaging tests after 1 month, 6 months, 1 year, and once a year for the rest of your life.

These tests are performed to make sure that the stent graft is working correctly and is in the right position. These tests will become less frequent, with the progress of your health conditions.

When to call your doctor?

Contact your doctor immediately, if you experience the below symptoms.

  • Pain, numbness, coldness or weakness in your legs or buttocks
  • Any back, chest, abdominal or groin pain
  • Dizziness, fainting, rapid heartbeat or sudden weakness
  • You should also call your doctor if you are required to reschedule your follow-up visit for any reason.
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