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Aortic abdominal aneurysm repair (AAA) - EVAR

An abdominal aortic aneurysm (AAA) occurs when the walls of the main blood vessel that carries blood away from the heart (the aorta) are bulging or dilated. It is located in the abdominal area. Aneurysms can also occur in other areas of the aorta, but the abdomen is the most common site. AAA can be repaired either through “open surgery” or with the use of an “endovascular stent graft" (Endovascular aneurysm repair = EVAR) EVAR is a minimally invasive surgery to repair an aneurysm. It is performed through a small hole in the groin, rather than the large incision across the abdomen used in traditional surgery. Usually, it is performed in a hybrid theatre under X-ray guidance with the option to convert to open surgery if needed. EVAR is less invasive than open surgery and is now the preferred method to repair an AAA.
  • Speciality Vascular 
  • Urgency elective, urgent, emergency 
  • Duration to 4 h
  • Blood Loss 250  to 2 litres (+/- Blood Transfusion)
  • Anaesthesia General Anaesthetic +/- Local Anaesthetic, Regional Anaesthetic - Epidural 
  • Anaesthesia II Local Anaesthetic, +/- Sedation 
  • Procedures Arterial line, Central line, X-ray 
  • Pain mild (+) 
  • Post-op Pain II Tablets, Suppositories, Injection (im, iv) 
  • Hospital Stay 1   to 3 days
  • Full Recovery 2   to 4 weeks
  • Additional Info A small incision is made in an artery in the groin. A short tube, called a sheath, is then placed into the artery to keep it open while a thin, flexible tube called a catheter is inserted into the femoral artery and directed to the aortic aneurysm. Contrast (dye) is injected into the catheter and shows up on the x-ray monitor. A metallic spring with a cover (stent graft) that is compressed into a small diameter is passed through the catheter. The stent graft is advanced to the aneurysm and then opened, creating new walls in the blood vessel through which blood flows. When the stent is deployed (opened) it seals the aneurysm ( https://www.circulationfoundation.org.uk/help-advice/abdominal-aortic-aneurysm/endovascular-aneurysm-repair-evar) 
  • More Information AAGBI-Tutorial of the Week 2014 
  • created by Dr Agata Kapuscinska 

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