Endovascular surgery for an AAA (also known as endovascular abdominal aortic repair, EVAR) can be performed under local anesthetic and sedation, as the surgery typically only involves two small 1cm punctures in both groins to perform. This makes it more suitable for patients who are frail and who may not be very fit for general anesthesia.
A device known as an aortic stent is introduced via the groin punctures and advanced upwards to the area of the AAA. Accurate positioning of the aortic stent is then confirmed using X-rays as well as special dyes injected into the blood stream. The stent is deployed to exclude the diseased AAA segment from the main circulation pathway and prevent further flow of blood into the AAA. Overtime the AAA is expected to stabilize and not expand further thus removing the risk of a fatal rupture.
An EVAR operation typically takes around 1-2h to perform, and the patient would then be expected to recover overnight in a high dependency unit before being transferring to the general ward. Most patients can discharge 1-2 days after an EVAR operation with light activities advised for a minimum of 2 weeks before returning to their usual lifestyle.