EVAR and FEVAR

Vascular surgeons at UMass Memorial Health offer advanced, catheter-guided treatment for aortic aneurysms. Endovascular aneurysm repair (EVAR) is a less invasive alternative to open-chest surgery, so it carries fewer risks and helps you recover faster. It’s also a treatment option for people considered too high risk for open surgery. 

What to Expect During EVAR

EVAR is an endovascular procedure, meaning a surgeon operates on your aorta from inside blood vessels without making a large incision in your abdomen or chest. They use a stent-graft (a mesh tube covered in fabric) to reinforce the weakened part of your aorta. The stent-graft prevents blood from entering the aneurysm, which keeps the aneurysm from growing or rupturing.  

EVAR can last anywhere from four to six hours depending on the complexity of the procedure. Most people go home the day after their procedure. 

During EVAR, your doctor: 

• Makes a small incision in your upper leg
• Inserts a catheter and wire into your femoral artery, which leads to your aorta
• Uses imaging guidance to advance a stent-graft via the bloodstream to the aneurysm
• Expands the stent-graft and fastens it in place
• Checks to make sure blood is flowing properly through the stent-graft and not into the aneurysm
• Removes the catheter and closes the incision

_{(Permission for use of image of EVAR graft granted by Cook Medical, Bloomington, Indiana)}

Fenestrated EVAR (FEVAR)

Fenestrated endovascular aortic repair (FEVAR) is an advanced variation of EVAR for people with aneurysms close to the renal arteries that supply blood to your kidneys, intestines, liver, lungs and spine. Fenestrated and branched stent-grafts have openings and side arms that line up with the arteries that lead to your organs. We use CT scans to customize these stent-grafts to precisely fit your unique anatomy.

We are one of a few centers in the U.S. with access to custom-made, company manufactured stent grafts. This allows a vascular surgeon to make alterations to the custom endograft to perfectly fit your aneurysm and arteries. 

We perform FEVAR at our Center for Complex Aortic Disease at UMass Memorial Medical Center. 

Watch an animation of FEVAR.
_{(Permission for use granted by Cook Medical, Bloomington, Indiana)}

Benefits of EVAR and FEVAR

EVAR and FEVAR offers several benefits over open aortic surgery, including: 

• Easier recovery
• Less downtime
• Shorter hospital stay
• Smaller scars