Infrarenal abdominal aortic aneurysm: EVAR

Abstract

Since the advent of aortic aneurysm repair utilizing the aortic stent graft by Parodi and colleagues in the early 1990s, the endovascular management of aortic aneurysms (EVAR) has become an increasingly common treatment modality. Historically, abdominal aortic aneurysm (AAA) repair involved an open abdominal or retroperitoneal approach. For the first time, in 2006, a larger percentage of aneurysms were treated in an endovascular fashion in comparison with the open repair. EVAR has proven to be a safe and minimally invasive option for many patients. Furthermore, several randomized trials (OVER, EVAR-1 and 2, and DREAM trials) comparing EVAR to open repair over the last decade have shown improved perioperative outcomes with the endovascular approach; however, long-term mortality appears to be equal with both methods, and EVAR has been shown to have a higher re-intervention rate.