Endovascular aortic repair (EVAR) is a minimally invasive procedure used to repair aortic aneurysms and dissections that occur in the abdominal aorta.
Fenestrated EVAR (FEVAR) is an option for people with abdominal aortic aneurysms who don’t qualify for EVAR (about 10% of patients) because the aneurysm is too close to the arteries that branch off to the kidneys for the traditional EVAR to work.
At the University of Michigan Health Frankel Cardiovascular Center, our specialists are experienced in routine and emergency EVAR and FEVAR. Our goal is to provide the safest, most effective treatment and the best possible patient outcomes.
EVAR and FEVAR at the Frankel Cardiovascular Center
Our Comprehensive Aortic Program offers:
- Significant experience: We are the aortic program of choice for patients with both complex and routine aortic conditions. We also help patients who had unsuccessful treatments elsewhere. Our doctors have experience performing all types of open and endovascular aortic procedures, including EVAR and FEVAR.
- Customized treatments: With EVAR and FEVAR, it’s important to tailor the stent grafts to each patient. This requires careful evaluation and measurements using CT scans. Customized stents take several weeks to make. In emergency situations, our doctors can make the stents for immediate use.
- Innovation: Endovascular techniques are continually evolving. You’ll receive care from specialists who are at the forefront of aortic research and treatment.
- Multidisciplinary team: Our cardiologists, surgeons, radiologists, anesthesiologists, nurse practitioners, physician assistants, nurses and technicians meet weekly to coordinate your care. We collaborate closely before, during and after your procedure.
- Close follow-up: Though endovascular procedures require shorter hospital stays, your recovery is our top priority. Our nurse coordinators will track your progress after you leave the hospital and we will follow you long-term.
Aortic Aneurysms and Dissections
The aorta is the largest blood vessel in the body. It starts at the heart, travels briefly toward the head then curves downward toward the abdomen. In the lower abdomen, the aorta branches into two femoral arteries that carry blood to each leg.
An aortic aneurysm is a bulge in the aortic wall. A dissection is a tear in the inner layer of the aorta that causes the inner and middle layers to separate. Both aneurysms and dissections are a concern because they weaken the wall of the aorta. If these weakened areas rupture, it can be fatal. Learn more about aortic aneurysms and dissections.
EVAR and FEVAR Procedures: What to Expect
With EVAR and FEVAR, stents (metal mesh tubes covered with fabric) are inserted inside the aorta. The stent supports the damaged section of the aorta and allows proper blood flow.
The doctor guides a collapsed stent to the aneurysm or dissection through a catheter (thin tube) inserted into the femoral artery in the groin. Once the stent is in place, the doctor expands it and ensures it fits securely.
EVAR is used in the lower section of the abdominal aorta, just above the point where the femoral arteries branch off. FEVAR is used in the upper abdominal aorta where the renal arteries branch off to the kidneys. FEVAR stent grafts have holes, or fenestrations, that line up with the branching arteries and allow blood to flow to these areas.
FEVAR stent grafts must be customized based on a patient’s anatomy and the location of the aneurysm or dissection. Our doctors use skill and precision in making the proper measurements and placing the stent grafts.
Sometimes an aneurysm or dissection spans several areas of the aorta. In these cases, our teams develop an individualized treatment plan that may include both open and endovascular techniques. We can offer patients these tailored, hybrid approaches because many of our surgeons specialize in these procedures.
Benefits of EVAR and FEVAR
People who are not candidates for open surgery due to other health conditions can be treated using EVAR and FEVAR. And because these procedures are minimally invasive, you spend less time in the hospital and recover faster.
But not all abdominal aortic aneurysms and dissections can be treated with endovascular procedures. Your doctor will work with you to determine the right approach based on your condition, medical history and risk factor
EVAR and FEVAR Illustrations
- Endovascular Repair (EVAR) of Infrarenal Aortic Aneurysm (PDF)
- FEVAR - Fenestrated Endovascular Aneurysm Repair (PDF)
Make an Appointment
Physicians: To refer a patient, call M-Line at 800-962-3555.