Vascular surgeons use many types of treatments to fix damaged blood vessels. For some patients, endovascular surgery — a less invasive option than open surgery — can offer many benefits, from a shorter hospital stay to a quicker recovery time.
But like all medical procedures, endovascular surgery isn’t without risks. Find out more about the pros and cons of endovascular surgery and how to talk with your surgeon about what’s right for you.
What Is Endovascular Surgery?
Endovascular means “inside the blood vessel.” Endovascular surgery is a type of procedure that uses very small cuts and long, thin tubes called catheters, which are placed inside a blood vessel to repair it.
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What Does It Treat?
This procedure is used to treat many types of conditions. It is commonly used to treat aneurysms, or weak spots or bulges in your arteries. Aneurysms can happen in any artery, but are most common in your abdominal aorta, the part of your largest artery that brings blood into your abdomen.
Open vs. Endovascular Aneurysm Repair
During open surgery, a vascular surgeon makes a large cut to access your artery, then removes the damaged portion and replaces it with a graft. A graft is a tube that allows blood to flow without putting pressure on your damaged vessel wall, keeping the aneurysm from rupturing and leading to life-threatening internal bleeding.
During endovascular aneurysm repair (EVAR), the surgeon makes small punctures in your groin and inserts a catheter into your blood vessel. Using special x-ray guidance, the surgeon moves the catheter containing a stent graft, a device made of fabric and metal mesh, to the site of the aneurysm.
The stent graft expands and anchors in place above and below the aneurysm to support your blood vessel and allow blood to flow through it properly. If your aneurysm is close to other arteries, like the arteries that bring blood to your kidneys, your surgeon may use a special type of stent graft with windows that allow blood to flow through to those arteries.
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Benefits and Risks of Endovascular Surgery
Endovascular surgery can result in a faster recovery time and fewer complications than open surgery. Many patients can go home one or two days after surgery and are back to their normal activities in two to four weeks.
Unlike open surgery, EVAR requires more follow-up visits with your vascular surgeon. You will need more imaging tests to make sure your stent graft is working properly and may need additional procedures to correct problems as you age.
Like all medical procedures, endovascular surgery is not without risks. Some risks can include:
- Endoleak, which happens when blood continues to flow in the aneurysm area. This may happen because the stent graft hasn’t properly sealed.
- Stent movement or failure
- New aneurysms that form above or below the original aneurysm site
Talking to Your Surgeon About Endovascular Surgery
Your vascular surgeon will determine whether open or endovascular surgery is best for you based on your anatomy, your risk factors, and the size of your aneurysm. Some questions you may want to ask include:
- What are all of my treatment options?
- What are the pros and cons of each of my treatment options?
- What will happen during my surgery?
- How many of these surgeries have you done?
- How long will I need to stay in the hospital?
- How long will it take for me to get back to my normal activities?
- How much follow-up care will I need?
The UPMC Heart and Vascular Institute has long been a leader in cardiovascular care, with a rich history in clinical research and innovation. As one of the first heart transplant centers in the country and as the developer of one of the first heart-assist devices, UPMC has contributed to advancing the field of cardiovascular medicine.