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Endovascular aneurysm repair involves the transfemoral or transiliac placement of a endograft within the aneurysm, with the aim of completely excluding the aneurysm sac from the circulation. Hybrid procedures offer one option, but a more direct approach involves the use of a branched endograft. Endovascular repair is a preferred treatment for many people with an abdominal aortic aneurysm (AAA), and an alternative for some who do not qualify for open surgery. [46] The first endovascular repair of a ruptured abdominal aortic aneurysm was also reported from Nottingham in 1994.[47]. This article focuses on the indications, contraindications, diagnostic studies, procedure, complications, nursing considerations, and patient discharge instructions for patients undergoing TEVAR. Thoracic endovascular aortic repair (TEVAR) is a procedure to repair the major blood vessel in the body called the aorta. If your situation is not an emergency, consider getting a second opinion or ask about all your treatment choices before having an endovascular aortic repair. Alternatively, a specially designed endograft, (an iliac branch device) can be used to preserve flow to the internal iliac arteries. Type II - Retrograde flow to the aneurysm sac from branches such as the. Local or general anesthesia might be used but it is not a surgery. At this point, an aneurysm is at risk of rupturing and causing  potentially fatal bleeding, just as a balloon will pop when blown up too much. This procedure is long, technically difficult, and currently only performed in a few centers. A branched endograft has graft limbs that branch off of the main portion of the device to directly provide blood flow to the kidneys or the visceral arteries. Stents: Large bare-metal stents have been used to treat proximal endoleaks, as have aortic extension cuffs to treat endograft migration. Abdominal endovascular aneurysm repair (EVAR) is a minimally invasive alternative to major open surgery for the repair of abdominal aortic aneurysms (AAAs) that results in reduced recovery times and potentially improved survival rates. However, there have been no RCT confirming the efficacy of … Endovascular repair: This is a minimal invasive procedure which involves inserting a catheter (long flexible tube) over a guide wire, into the artery of the groin and guiding it to the aneurysm. Thoracic aortic aneurysms are those that occur along the aorta above the diaphragm, the partition between the chest and abdomen, including the ascending aorta, the aortic arch, and the descending thoracic aorta. Continued improvement in stent graft design, including branched endografts, will reduce but not eliminate multi-stage procedures. Endovascular aortic aneurysm repair is a procedure to fix a weak and bulging section of the aorta. Snorkel: A covered stent placed into a visceral vessel adjacent to the main body of the EVAR device. Type 2 leaks are common and often can be left untreated unless the aneurysm sac continues to expand after EVAR. Endovascular repair is a type of treatment for an abdominal aortic aneurysm, or AAA. When used to treat thoracic aortic disease, the procedure is then specifically termed TEVAR for "thoracic endovascular aortic/aneurysm repair." How an AAA is repaired varies depending on location, which then classifies the procedure as either STANDARD or COMPLEX. The doctor will make one or two cuts (incisions) in the groin area. [8][9][10][11] The procedure can be performed under general, regional (spinal or epidural) or even local anesthesia. The advantage of this type of repair is that there is no abdominal surgery. Artery that carries blood to flow through, protecting the surrounding anatomy including open surgery have demonstrated a reduction T2EL! 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