Fixing Aneurysms Without Open Surgery: What Is Endovascular Repair

Endovascular repair is a minimally invasive approach that allows clinicians to fix aneurysms using catheters and a stent graft placed through the blood vessels, avoiding the large incisions and long recovery of open surgery. By sealing the aneurysm off from blood flow, this technique prevents further expansion and greatly reduces the risk of rupture. It is used widely for abdominal and thoracic aortic aneurysms and is also applied to many brain aneurysms.

Endovascular aneurysm repair, known as EVAR for abdominal aneurysms and TEVAR for thoracic aneurysms, involves placing a covered stent called a stent graft inside the weakened portion of the artery. The device is introduced through a small access point in the groin and guided to the aneurysm with X-ray imaging. Once in place, it creates a new channel for blood to flow through, isolating the aneurysm sac from pressure.

The procedure begins with small incisions or needle punctures in the femoral arteries, through which guidewires and catheters are threaded up to the aneurysm. After the stent graft is positioned, it is expanded so it seals firmly against healthy artery both above and below the weakened area. For aneurysms located near critical branching arteries, such as those supplying the kidneys or abdominal organs, grafts may be used to preserve blood flow to these vessels.

Moreover, compared with open surgery, endovascular repair typically results in less pain, shorter hospital stays, faster recovery, and lower early complication rates. These advantages can be especially important for older adults or patients with additional health risks. However, the technique is not appropriate for everyone. It requires enough healthy artery for the graft to anchor securely, and certain features may require open surgery or more advanced devices. The risks include endoleaks, movement of the graft, blockage of the graft limbs, kidney injury from contrast dye, and the need for lifelong imaging follow-up and possible re-interventions.

In addition, endovascular approaches are also widely used for brain aneurysms. Techniques such as coiling, stent-assisted coiling, and the placement of flow diverter stents allow treatment from inside the blood vessels of the brain without a craniotomy. These methods work by filling the aneurysm or redirecting blood flow so the sac clots and stabilizes.

Overall, endovascular repair offers a powerful alternative to open surgery for many patients with aneurysms. By treating the problem from within the blood vessel, it provides effective protection against rupture with a safer, less invasive recovery.

by Anonymous (KQ) at Incisionary

APA References

Clinic, Cleveland. “Endovascular Aneurysm Repair Lowers the Risk of Life-Threatening Tears or Ruptures. EVAR Uses Minimally Invasive Techniques to Reinforce Blood Vessel Walls.” Cleveland Clinic, 26 Jan. 2022, my.clevelandclinic.org/health/treatments/22291-endovascular-aneurysm-repair. Accessed 23 Nov. 2025.

“Endovascular Repair of an Abdominal Aortic Aneurysm.” Www.hopkinsmedicine.org, www.hopkinsmedicine.org/health/conditions-and-diseases/abdominal-aortic-aneurysm/endovascular-repair-of-an-abdominal-aortic-aneurysm.

“Endovascular Treatment - Brain Aneurysm Foundation.” Brain Aneurysm Foundation, 10 June 2024, www.bafound.org/treatment-recovery/treatment-options/endovascular-treatment/.

“Thoracic Endovascular Repair for Aortic Aneurysm (TEVAR) Procedure.” UPMC | Life Changing Medicine, 2024, www.upmc.com/services/heart-vascular/services/procedures/tevar.