What is an Endovascular Graft?

Jacquelyn Gilchrist

An endovascular graft is a minimally invasive surgery to treat patients with an abdominal aortic aneurysm (AAA). Also called an endovascular stent graft or endovascular grafting, this procedure uses small incisions to guide a stent graft to the aneurysm to help support the walls of the artery. The stent graft, a tube made of fabric and metal wires, remains in the artery to prevent the aneurysm from bursting. Patients may expect a recovery time of about four to six weeks, including two to four days in the hospital after the endovascular graft.

An endovascular graft uses small incisions to guide a stent graft to an aneurysm to help support the walls of the artery.
An endovascular graft uses small incisions to guide a stent graft to an aneurysm to help support the walls of the artery.

Candidates for this surgery have an aneurysm in the artery that carries blood to the legs, abdomen, and pelvis. An aneurysm occurs when a portion of a blood vessel becomes weak and widens, or bulges. These areas are in danger of rupturing, which causes blood leakage. An endovascular graft must be performed on aneurysms that have not ruptured in order to prevent this complication.

To prepare for an endovascular graft, the surgeon will evaluate imaging tests to determine the size and exact location of the aneurysm. Patients will likely undergo other tests, such as blood or urine tests, to ensure their general health. This type of surgery may be performed with regional anesthesia and a sedative; however, the patient may also request general anesthesia so that he is asleep throughout the procedure. The patient must disclose his other medical conditions, medications, and supplements prior to the endovascular graft procedure to minimize complications and risks.

Once the anesthesia has taken effect, the endovascular graft will begin with small incisions made in the groin area. A catheter is then inserted and guided through the artery in the thigh until it reaches the aneurysm. Once it reaches the site, a stent graft is released from the catheter. The graft will expand to support the arterial walls and the surgeon will remove the catheter. Large aneurysms may require more than one graft.

This surgery generally takes two to four hours to complete. Following an endovascular graft surgery, patients can expect to recover in the hospital for two to four days. They must follow their surgeon's instructions during their recoveries, which may take four to six weeks. Strenuous activities must be avoided, and patients should delay driving for one to two weeks. Pain relievers will likely be prescribed to alleviate any discomfort.

Before undergoing this surgery, patients should talk to their doctors about the potential risks. Fatigue and a low-grade fever may occur temporarily. Some patients experience loss of appetite, malaise, and swelling or numbness of the thighs. Nausea and vomiting have also been reported. Patients should call their doctors if they experience dizziness, fainting, or sudden weakness, along with any swelling.

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