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Endovascular aneurysm repair (EVAR) is a type of minimally-invasive endovascular surgery used to treat pathology of the aorta, most commonly an abdominal aortic aneurysm (AAA). When used to treat thoracic aortic disease, the procedure is then specifically termed TEVAR for "thoracic endovascular aortic/aneurysm repair."
Prior to the advent of endovascular aneurysm repair (EVAR), OAS was the only surgical treatment available for aortic aneurysms. The shift away from open aortic surgery towards endovascular surgery since 2003 has been driven by worse perioperative mortality associated with OAS, particularly in patients in relatively frail health. [2]
Abdominal aortic aneurysm; CT reconstruction image of an abdominal aortic aneurysm (white arrows) Specialty: Vascular surgery: Symptoms: None, abdominal, back, or leg pain [1] [2] Usual onset: Over-50-year-old males [1] Risk factors: Smoking, hypertension, other cardiovascular disease, family history, Marfan syndrome [1] [3] [4] Diagnostic method
For abdominal aneurysms, the current treatment guidelines for abdominal aortic aneurysms suggest elective surgical repair when the diameter of the aneurysm is greater than 5 cm (2 in). However, recent data on patients aged 60–76 suggest medical management for abdominal aneurysms with a diameter of less than 5.5 cm (2 in).
Inflammatory Aortic Aneurysms occur typically in a younger population compared to the typical Abdominal Aortic Aneurysm group. Risk of rupture for the IAA group, due to thinning of aneurysm walls, are also rare due to inflammation and fibrosis [4] Unruptured inflammatory AAAs are usually symptomatic: [citation needed] abdominal or back pain (70 ...
Lucille Ball was diagnosed with dissecting aortic aneurysm and underwent surgery to repair her aorta and a successful seven-hour aortic valve replacement, but died days later. [52] A greater incidence of aortic aneurysm is seen in cigarette smokers; Ball had been a heavy smoker most of her life. [53]
All patients with a thoracic aortic injury need to be treated either surgically with endovascular repair or open surgical repair or with medicine to keep their blood pressure and heart rate in the appropriate range. [3] However, most patients that have a thoracic aortic injury do not live for 24 hours. [4]
Common features of both techniques of the replacement process are the clamping of the aorta and the use of a length of Dacron tube (also known as an "aortic graft"), typically 5 cm, to constrict the aortic root to the normal diameter, while the patient is cooled to 20°C and placed on life support. The procedure typically takes 4 to 6 hours in ...
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