Endovascular Aneurysm Repair (EVAR)

Endovascular aneurysm repair (EVAR) is a minimally invasive treatment for aortic aneurysms and some dissections. Our surgeons operate on your aorta from inside blood vessels, via a catheter, instead of doing open-chest surgery. Henry Ford Health was the first in Michigan to perform EVAR more than three decades ago . We continue to pioneer the latest treatments to help you achieve the best possible outcomes.

Why choose Henry Ford for minimally invasive aortic aneurysm surgery?

We’re known throughout the region for our ability to treat the most complex aortic diseases using an endovascular approach. Our Aortic Disease Program is among only a few programs in Michigan to offer EVAR for aneurysms in the ascending aorta, aortic arch and thoracoabdominal aorta — all known as difficult areas to treat.

Our Aortic Disease Program offers you:

• Treatments for high-risk patients: Endovascular repair offers a treatment when you aren’t a candidate for open aortic surgery due to advanced age, poor health or other heart conditions. Catheter-based treatment results in a shorter, less painful recovery than traditional open surgery.
• Research and innovation: Our doctors investigate new uses for branched, fenestrated (containing holes that line up with arteries) and physician-modified stent grafts. The physician customizes the graft, a mesh tube, to suit the patient’s specific anatomy. By pioneering the latest devices, we’re setting a new standard for endovascular repair.
• Hybrid OR: Our state-of-the-art hybrid operating room allows us to combine open and endovascular techniques in a single procedure. Hybrid procedures are shorter and less invasive than traditional open surgery, so they carry fewer risks.
• Team approach: Our program combines the expertise of multiple aortic disease specialists under one roof. Vascular surgeons, heart surgeons, cardiologists, interventional radiologists and cardiovascular anesthesiologists work together to plan your treatment.

What is endovascular aneurysm repair (EVAR)?

Endovascular aneurysm repair means we operate on aortic aneurysms and dissections from inside your blood vessels. We insert catheters and wires through small incisions or needle punctures, usually in your groin or chest. We guide stent-grafts through the catheter and implant them in the damaged part of your aorta. Stent-grafts can prevent aneurysms from dissecting (tearing) or rupturing (bursting).

Learn more about our minimally invasive procedures:

• Endovascular aneurysm repair (EVAR)
• Fenestrated endovascular aneurysm repair (FEVAR)
• Thoracic endovascular aneurysm repair (TEVAR)

Endovascular repair for complex aortic diseases

We can often perform catheter-based or hybrid procedures on parts of your aorta that are especially challenging to treat, such as the ascending aorta and aortic arch.

In the past, aneurysms or dissections in these areas required open surgery. But advances in endovascular techniques, combined with our extensive experience, means we can now treat you even if you can’t tolerate the risks of traditional open surgery. We’re one of only a few programs in Michigan to offer these innovative procedures.

Endovascular aortic arch repair

Aneurysms in the ascending aorta and aortic arch are difficult to treat due to their:

• Branches that supply blood to the head and arms
• Curved shape, which can vary from person to person
• Proximity to the heart and brain

At Henry Ford, we’re investigating new ways to use branched and fenestrated stent-grafts to repair ascending aorta and aortic arch aneurysms. We’re also experimenting with customized laser-fenestration, meaning we use a laser to puncture holes in a stent-graft during surgery to precisely tailor the device to your anatomy. Endovascular repair of the arch is less invasive and can be offered to high-risk patients who are not candidates for open repair.

Hybrid aortic repair: frozen elephant trunk procedure

Our cardiac and vascular surgeons have experience performing both open and endovascular aortic repairs. In some cases, we combine these techniques into a single hybrid procedure.

One example of hybrid repair is the frozen elephant trunk procedure. We use this approach if you have aneurysms in both the aortic arch and descending aorta. It’s particularly useful for people with connective tissue disorders, such as Marfan syndrome, who are prone to extensive aneurysms.

During the hybrid frozen elephant trunk procedure, we use open-chest surgery to repair the aortic arch with a traditional graft. During the same procedure, we use a catheter to implant an endograft in the descending aorta. The second stent-graft makes future endovascular interventions on the thoracic aorta possible, so people avoid multiple open surgeries.

Endovascular thoracoabdominal aortic aneurysm repair

Heart and vascular surgeons work together to repair thoracoabdominal aortic aneurysms (TAAA) that extend from the chest to the belly. These aneurysms are complex and dangerous due to their large size and their many branches that supply blood to the stomach, intestines, liver, kidneys and other vital organs.

Our surgeons are developing the use of special branched stent-grafts, deployed through catheters in the chest and groin, to reinforce the aorta while allowing blood flow to organs. This approach involves less trauma to your body and reduces the risk of spinal cord damage and paraplegia.