Endovascular aneurysm repair is a minimally invasive treatment for abdominal aortic aneurysm (AAA) that can reinforce the weakened portion of the aorta without the need for traditional open surgery. TGH offers EVAR and a full range of vascular surgery services to patients throughout Brooksville, Spring Hill, Crystal River and surrounding communities. Procedures are performed at TGH Brooksville, with vascular evaluations, preprocedural planning and long-term aneurysm surveillance conveniently available throughout the region.
What Is Endovascular Aneurysm Repair?
EVAR is a stent-graft-based procedure that can redirect blood flow away from an AAA, reducing pressure on the aneurysm and helping prevent rupture. An abdominal aortic aneurysm occurs when a weakened area of the abdominal aorta—the large artery that carries oxygen-rich blood from the heart to the lower body—enlarges or bulges outward. As the aneurysm grows, the wall of the aorta may become more vulnerable to rupture, which can cause life-threatening internal bleeding.
Rather than accessing the aneurysm through a large abdominal incision, EVAR allows the vascular surgeon to repair the affected section of the aortic wall from inside the blood vessels. Using imaging guidance, the surgeon will advance a stent graft through the artery and position it across the aneurysm. The graft will then redirect blood flow through the reinforced section of the aorta, reducing pressure on the aneurysm and helping to prevent rupture.
When Is Endovascular Aneurysm Repair Recommended for Abdominal Aortic Aneurysm?
Not every AAA requires immediate repair. A small aneurysm that is not causing symptoms may be monitored with periodic imaging. Intervention may be recommended if the aneurysm reaches a certain size, grows rapidly, causes symptoms or is at increased risk of rupture.
Candidacy for EVAR depends on more than the size of the aneurysm, however. The vascular surgery team will carefully evaluate the shape and location of the weakened area of the arterial wall as well as the size, condition and arrangement of the surrounding blood vessels. These anatomical factors can help determine whether a stent graft can be securely positioned and provide an effective seal. If the patient’s anatomy is not suitable for endovascular aneurysm surgery, traditional open aneurysm repair or another treatment approach may be recommended.
How Does Endovascular Aneurysm Repair Differ From Open Aneurysm Repair?
Both EVAR and open aneurysm repair are designed to prevent an abdominal aortic aneurysm from rupturing, although each procedure accomplishes this in a different way. The open approach generally requires a large abdominal incision so the surgeon can directly access the affected portion of the aorta and replace it with a surgical graft.
By contrast, endovascular aneurysm repair is performed from within the blood vessels, typically through small access points near the groin. Because this approach does not require a large abdominal incision, it generally involves less tissue disruption and a shorter initial recovery than open repair. That said, EVAR is not necessarily the right option for every patient. Open surgery may provide a more appropriate or durable repair for certain aneurysm anatomies or individual circumstances.
What Happens During the EVAR Procedure?
When performing endovascular aneurysm repair, the vascular surgeon will make a small incision or puncture near the groin to access an artery. Using imaging guidance, the surgeon will carefully advance a thin catheter carrying a compressed stent graft through the blood vessels to the abdominal aortic aneurysm.
Once in place, the endovascular stent graft will be expanded inside the aorta, sealing against the healthy sections of the artery above and below the aneurysm. This will allow blood to flow through the graft rather than placing direct pressure on the weakened aortic wall.
Throughout the EVAR procedure, the vascular surgery team will use detailed imaging to confirm the positioning of the graft and evaluate blood flow. The exact surgical technique and type of graft used can vary based on the patient’s vascular anatomy and the characteristics of the aneurysm.
What Is Recovery Like After Endovascular Aneurysm Repair?
Because EVAR is less invasive than traditional open AAA repair, it is generally associated with a shorter hospital stay and recovery period. Most patients can gradually return to their normal routines according to their vascular surgeon’s instructions, although the timeline for resuming work, exercise and other daily activities can vary.
The specifics of the recovery process will depend on several key factors, including the patient’s age and overall health, the complexity of the EVAR procedure and whether any complications occur. The patient will receive individualized discharge instructions and attend follow-up appointments so the vascular surgery team can assess the healing progress and monitor the repair.
Recovery from endovascular aneurysm repair does not mark the end of monitoring. An EVAR stent graft will require ongoing surveillance to ensure it continues to function as intended.
What Are the Risks of Endovascular Aneurysm Repair?
Although EVAR avoids the large incision associated with open aneurysm repair, it is still a major vascular procedure that carries certain risks. Possible complications include:
- Bleeding
- Infection
- Blood vessel injury
- Blood clots
- Kidney problems related to the contrast dye used to visualize the blood vessels
- Issues involving the stent graft
Another potential complication specific to endovascular aneurysm repair is an endoleak, which can occur if blood continues to flow into the aneurysm sac outside the stent graft. Some endoleaks can be monitored, while others may require an additional procedure. The graft may also shift from its original position or develop other problems over time.
Before recommending EVAR, the vascular surgery team will weigh these potential risks against the risks posed by the aneurysm and explain what the patient may expect from treatment.
Why Is Long-Term Follow-Up Imaging Important After Endovascular Aneurysm Repair?
Long-term surveillance will be an essential part of AAA treatment after EVAR. Although the stent graft will redirect blood flow away from the weakened portion of the aorta, the aneurysm will remain in the body and the graft must continue to maintain an effective seal to function properly.
Follow-up imaging will allow the vascular surgery team to monitor the aneurysm and stent graft over time. EVAR surveillance imaging can identify an endoleak, graft movement, changes in aneurysm size and other concerns that may require closer observation or additional treatment.
The patient should continue with their recommended imaging appointments even if they feel well and have no symptoms. The type and frequency of imaging will be determined by the vascular surgery team based on the specifics of the repair, prior imaging findings and the patient’s individual needs.
Consult With Our Vascular Surgery Services Team
If you have been diagnosed with an abdominal aortic aneurysm, the vascular surgery services team at Tampa General Hospital can determine whether EVAR, open aneurysm repair or another treatment approach may be appropriate for you. Our team will carefully evaluate your aneurysm anatomy, overall health and individual risk factors before recommending a tailored treatment plan.
Endovascular aneurysm repair and other vascular procedures are performed at TGH Brooksville, with coordinated access to evaluations and ongoing follow-up for patients across Brooksville, Spring Hill, Crystal River and surrounding communities. Contact Tampa General Hospital to schedule a consultation or learn more about AAA treatment options. We are proud to be ranked No. 1 in the Tampa Bay region for Cardiology, Heart & Vascular Surgery by U.S. News & World Report for 2026-27.