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Endovascular Aneurysm Repair (EVAR)

Hope and Healing through Endovascular Aneurysm Repair (EVAR), Accredited by ABH and JCI

Endovascular Aneurysm Repair | Endovascular Aneurysm Repair Procedure

Overview

Endovascular aneurysm repair, commonly known as EVAR, is a minimally invasive procedure used to treat aneurysms of the aorta, most often in the abdomen. An aneurysm occurs when a section of the artery wall becomes weak and balloons outward, creating a risk of rupture. EVAR allows doctors to reinforce the weakened artery from within, reducing the risk of life-threatening bleeding. At Manipal Hospitals International, EVAR is performed using advanced imaging technology and experienced vascular teams, ensuring precision, safety, and faster recovery for patients.

What is Endovascular Aneurysm Repair?

Endovascular aneurysm repair is a procedure that strengthens a weakened section of the aorta using a special stent-graft. Instead of opening the abdomen, doctors guide the graft through blood vessels using thin tubes called catheters.

In simple terms, the endovascular aneurysm repair procedure places a supportive lining inside the artery to prevent the aneurysm from growing or bursting.

Why is the Endovascular Aneurysm Repair Procedure Needed?

EVAR is recommended when an aneurysm reaches a size or shape that increases the risk of rupture. Without treatment, a ruptured aneurysm can cause severe internal bleeding and is often life-threatening.

Common Reasons and Key Conditions Treated

  • Abdominal aortic aneurysms were detected on imaging.
  • Rapidly enlarging aneurysm.
  • An aneurysm causing pain or pressure symptoms.
  • High risk of rupture based on size and location.
  • Patients unsuitable for open surgical repair.

Types of Endovascular Aneurysm Repair / Procedure Variations

The approach to EVAR depends on aneurysm location, artery shape, and patient anatomy. Careful planning ensures the most appropriate technique is selected.

  • Standard EVAR: Uses a straight or bifurcated stent-graft for abdominal aneurysms.
  • Fenestrated EVAR: Designed for aneurysms close to vital artery branches.
  • Branched EVAR: Includes side branches to maintain blood flow to organs.
  • Emergency EVAR: Performed urgently in selected ruptured aneurysms.

Why Choose Manipal Hospitals for Endovascular Aneurysm Repair?

Manipal Hospitals offers comprehensive vascular care supported by experienced surgeons, interventional specialists, and advanced imaging facilities. Each EVAR procedure is carefully planned and executed to achieve durable results.

  • Experienced vascular and endovascular surgeons.
  • State-of-the-art catheterisation and imaging labs.
  • Minimally invasive approach with reduced recovery time.
  • Strict safety and infection control protocols.
  • Dedicated international patient care coordination.

Indications for Endovascular Aneurysm Repair

EVAR may be advised when:

  • The aneurysm size exceeds safe limits.
  • There is a risk of rupture based on imaging.
  • The patient has symptoms related to the aneurysm.
  • Open surgery carries higher risk.
  • Overall anatomy is suitable for stent-graft placement.

Who Should Avoid or Delay Endovascular Aneurysm Repair?

Some patients may not be suitable for EVAR or may require alternative approaches.

  • Aneurysm anatomy unsuitable for stent anchoring.
  • Severe infection affecting the bloodstream.
  • Allergy to contrast dye without alternatives.
  • Advanced kidney disease requiring special planning.
  • Small, stable aneurysms suitable for monitoring.

Preparing for Endovascular Aneurysm Repair

  • Detailed CT angiography to map blood vessels.
  • Cardiac and anaesthetic evaluation.
  • Blood tests and kidney function assessment.
  • Medication review, including blood thinners.
  • Travel and accommodation planning for international patients.

What Happens During the Endovascular Aneurysm Repair Procedure?

The procedure is performed under general or regional anesthesia. Small incisions are made in the groin, and catheters are guided to the aneurysm site. The stent-graft is positioned and expanded to reinforce the artery.

Step-by-Step Breakdown

  • Admission and final pre-procedure checks.
  • Access to blood vessels through the groin.
  • Guidance of catheters using real-time imaging.
  • Deployment of the stent-graft inside the aneurysm.
  • Confirmation of proper placement and blood flow.
  • Closure of access sites and recovery monitoring.

Recovery After Endovascular Aneurysm Repair

Recovery after EVAR is usually quicker than after open surgery. Most patients are able to walk within a day and experience minimal discomfort at the access sites.

Hospital stays typically range from two to four days. Regular follow-up imaging is important to ensure the graft remains secure and effective.

Risks & Complications

EVAR is generally safe but may carry risks such as bleeding, infection, graft movement, or leakage around the graft. Kidney strain from contrast dye is also possible. Careful planning and close monitoring reduce these risks.

Benefits of Endovascular Aneurysm Repair

  • Minimally invasive treatment option.
  • Lower surgical stress compared to open repair.
  • Shorter hospital stay and faster recovery.
  • Reduced risk of aneurysm rupture.
  • Improved safety for high-risk patients.

What is the cost of Endovascular Aneurysm Repair at Manipal Hospitals?

The cost of EVAR depends on the type of stent-graft, imaging requirements, and length of hospital stay. Manipal Hospitals offers advanced aneurysm repair procedures at costs that are significantly more affordable compared with many Western and Gulf countries, while maintaining international standards of care.

Personalised cost estimates are provided after detailed imaging and clinical evaluation.

International Patient Support at Manipal Hospitals

International patients receive comprehensive support, including medical record review, visa assistance, travel coordination, interpreter services, accommodation guidance, and structured follow-up care to ensure continuity and comfort throughout treatment.

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Frequently Asked Questions

For many patients, EVAR is safer because it avoids large incisions and reduces recovery time. Suitability depends on aneurysm anatomy and overall health.
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