EVAR
You don't need to be Editor-In-Chief to add or edit content to WikiDoc. You can begin to add to or edit text on this WikiDoc page by clicking on the edit button at the top of this page. Next enter or edit the information that you would like to appear here. Once you are done editing, scroll down and click the Save page button at the bottom of the page.
| Cardiology Network |
 Discuss EVAR further in the WikiDoc Cardiology Network |
| Adult Congenital |
|---|
| Biomarkers |
| Cardiac Rehabilitation |
| Congestive Heart Failure |
| CT Angiography |
| Echocardiography |
| Electrophysiology |
| Cardiology General |
| Genetics |
| Health Economics |
| Hypertension |
| Interventional Cardiology |
| MRI |
| Nuclear Cardiology |
| Peripheral Arterial Disease |
| Prevention |
| Public Policy |
| Pulmonary Embolism |
| Stable Angina |
| Valvular Heart Disease |
| Vascular Medicine |
| WikiDoc Cardiology News |
 Read more about EVAR in the WikiDoc Cardiology News |
| All News Articles |
|---|
| Acute Coronary Syndromes |
| Biomarkers |
| Cardiovascular Imaging |
| CT Surgery |
| Diabetes |
| Electrophysiology |
| General Cardiology |
| Guidelines |
| Health Policy |
| Heart Failure |
| Hypertension |
| Interventional |
| Peripheral Arterial Disease |
| Prevention |
| Valvular Heart Disease |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-525-6884
Please Take Over This Page and Apply to be Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [2] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.
EVAR which stands for Endovascular Aneurysm Repair (or Endovascular Aortic Repair), is a type of Endovascular surgery used to treat an abdominal aortic aneurysm or AAA.
Patient Screening
Before patients are deemed to be a suitable candidate for this treatment, they have to go through a rigorous set of tests. These include a CT scan of the aorta and blood tests. The CT scan gives precise measurements of the aneurysm and the surrounding anatomy. In particular the calibre/tortuosity of the iliac arteries and the relationship of the neck of the aneurysm to the renal arteries are important determinants of whether the aneurysm is amenable to endoluminal repair.
The Procedure
The procedure is carried out in a sterile environment, usually a theatre, under x-ray fluoroscopic guidance. It is carried out by a vascular surgeon or an Interventional Radiologist who collaborate on most cases. The patient is either given a full GA (general anaestheic) or an epidural.
Vascular 'sheaths' are introduced into the patient's femoral arteries, through which the guidewires, catheters and eventually, the Stent Graft is passed.
Diagnostic angiography images or 'runs' are captured of the aorta to determine the location on the patient's renal arteries, so the stent can be deployed below these. The main 'body' of the stent graft is placed first, with the 'limbs' which join on to the main body and sit in the iliacs, placed later.
The idea is that the covered stent, once in place acts as a false lumen for blood to travel down, and not into the surrounding aneurysm sac. This therefore immediately takes the pressure off the aneurysm, which itself will thrombose in time.
Complications
Systemic
MI, CHF, arrhythmias, respiratory failure, renal failure
Procedure related
Dissection, malpositioning, renal failure, thromboembolizaton, ischemic colitis, groin hematoma, wound infection
Device related
Migration, detachment, rupture, stenosis, kinking
Endoleaks
Type I,II, III and IV
- Type I - Perigraft (persistent flow at proximal or distal attachment sites)
- Type II - Retrograde flow from collateral branches
- Type III - Fabric tears / graft disconnection
- Type IV - Graft wall porosity
External Links
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
