An endograft is a medical device designed to repair weakened sections of large blood vessels, primarily the aorta. It functions as an internal support structure, preventing further expansion or rupture. The device is a fabric tube, often made of polyester, that is supported by a metal mesh frame, known as a stent. This approach offers a less invasive alternative to traditional open surgery.
What Endografts Treat
Endografts are designed to treat aortic aneurysms, which are bulges or weakened areas in the wall of the aorta, the body’s largest artery. The aorta carries oxygenated blood from the heart to the rest of the body, extending through the chest and abdomen. When an aneurysm forms, the vessel wall balloons outward due to pressure from blood flow, which can lead to life-threatening complications.
Aneurysms pose a risk because they can rupture, causing severe internal bleeding. They can also lead to dissection, where the layers of the aortic wall separate, blood leaking between them, weakening the vessel. Aortic aneurysms are categorized by their location: abdominal aortic aneurysms (AAAs) occur in the abdomen, while thoracic aortic aneurysms (TAAs) develop in the chest. Both types can be treated with endografts, though AAAs are more commonly addressed with this method.
The Endovascular Aneurysm Repair Procedure
Endovascular aneurysm repair (EVAR) is a minimally invasive procedure that uses an endograft to reinforce the aorta. The procedure involves small incisions, often made in the groin area. A thin, flexible tube called a catheter is inserted into an artery, often the femoral artery, and guided through the blood vessels to the site of the aneurysm using imaging techniques.
The endograft, compressed within the delivery catheter, is threaded through the catheter to the aneurysm’s location. Once positioned accurately, the surgeon deploys the endograft, which expands and fastens against the inner wall of the aorta, reinforcing the weakened section and redirecting blood flow through the graft rather than into the aneurysm sac. This technique offers several advantages over traditional open surgery, including smaller incisions, reduced pain, shorter hospital stays, often 1 to 2 days, and a quicker recovery period.
Life After Endograft Placement
Following an endovascular aneurysm repair, patients typically remain in the hospital for observation. During this recovery period, medical staff monitor vital signs, kidney function, and check for any post-operative bleeding or infection. Patients may experience some discomfort, such as swelling in the upper thigh or mild leg pain, for the first few days.
Full recovery can take several weeks, with patients able to resume light activities within 1 to 2 weeks and returning to most normal activities within 4 to 6 weeks. Long-term follow-up is an important aspect of post-procedure care. Patients will require regular imaging tests, such as CT scans with contrast or duplex ultrasounds, typically at three, six, and twelve months after the procedure, and then annually thereafter. These imaging studies ensure the endograft remains correctly positioned and the aneurysm sac is not expanding or experiencing complications like an endoleak, which is blood flow outside the endograft within the aneurysm sac. Maintaining a healthy lifestyle with a balanced diet and regular, gentle exercise, as advised by a physician, also supports long-term vascular health.