Information for Patients

EVAR (Endovascular aneurysm repair) is a minimally invasive "keyhole" surgery to repair an aneurysm, typically located in the aorta of your belly.  It is performed through a small hole in your groin, which is much different than that of traditional surgical techniques.  It is performed in the radiology (x-ray) department by an interventional radiologist and a vascular surgeon.  With EVAR, the aneurysm is repaired using a special stent graft (endograft).  It is a small, fabric-wrapped, flexible mesh tube that is used to "patch" the enlarged section of the vessel.  It does so by being placed inside the artery, which strengthens it and prevents it from bursting. 

You will be admitted to a ward prior to the treatment and may need to stay in hospital overnight.

We typically recommend that you do not eat or drink anything except water for six hours before the procedure.  You can drink water up to 2 hours before the procedure.

Take all medication as normal. If you are an asthmatic or suffer from angina please bring your inhaler(s) and medication with you.

If you are taking medicines such as blood thinners (warfarin, aspirin or clopidogrel), these may need to be altered around the time of your scan.  Contact your GP or please feel free to telephone us if you have any questions or concerns about your medications. 

The following investigations involve exposure to x-rays.  X-rays consist of a type of radiation known as ionising radiation.  The doses that are used in medical x-rays are very low and the associated risks are minimal.  We keep the doses as low as possible and make sure that the benefits of having the x-ray outweigh any risk. 

Furthermore, the contrast dye that is used contains iodine, which some people are allergic to.  If you have had an allergic reaction to x-ray contrast in the past of if you have a known allergy to iodine, please let us know. 

The contrast dye can affect kidney function, but a pre-procedure blood test will be performed to assess your kidneys' function.

As vascular interventional procedures need access to your vessels, bleeding or bruising can occur under the skin.  This is very common, but takes one to two weeks to disappear.  Occasionally, the artery can be damaged during the procedure.  As with all skin-piercing procedures, wound infections are possible.

You will be given an epidural and a sedative, which is medication to help you relax.  You will, however, be awake during the procedure.  If you need more sedative, you will have a cannula in your arm and the medication will be injected through that.  

In the procedure room, you will lie on your back on the x-ray table.  The groin area will be cleaned with antiseptic fluid, and there will be a sterile drape over most of your body.  You will be given a local anaesthetic in your groin area, which might sting at first, but will settle almost immediately. 

Once numbed, an incision is made, a tube (sheath) will be placed in the artery to keep it open, and a catheter will be inserted into the artery located there.  This catheter will be pushed through your arterial system until it gets to the aneurysm. Contrast dye is used to visualise your arteries and will be administered using the catheter.  The stent will be placed on the end of the catheter and directed to the location of the aneurysm, using the catheter as a guide-wire for correct placement.  The stent is opened, and the aneurysm is sealed.   Following that, the catheter is removed, the incision in the groin is closed and the procedure is finished.

Some slight bruising of your groin may occur and your groin may ache for a day or two after the procedure. If you experience excessive pain or swelling when you return home, please contact your GP.

You can eat and drink straight away, but bed rest will be necessary. Typically, we prefer that our patients do not shower for at least 24 hours and do not drive or do any form of strenuous exercise for 48 hours after the procedure.