What Is Endovascular Surgery?

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Endovascular surgery is a procedure that is performed using minimally invasive catheter techniques on the arteries or veins. Procedures include aneurysm repair, grafts, stents, varicose vein repair, and more. Endovascular surgery is often performed on an outpatient basis. 

endovascular surgery prep

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Types of Endovascular Surgery

Types of endovascular procedures include:

  • Conditions of the aorta (aneurysms or occlusion)
  • Cardiovascular disorders
  • Peripheral vascular disease
  • Carotid artery disease
  • Critical limb ischemia
  • Deep vein thrombosis (DVT)
  • Pulmonary embolism
  • Renal (kidney) vascular disease
  • Stroke
  • Varicose veins
  • Hereditary disorders that result in various types of vascular disorders
  • Leg pain due to poor circulation

Advantages of Endovascular Surgery

There are many advantages to performing endovascular surgery, including:

  • A much shorter recovery period
  • Less pain
  • Performed in an outpatient setting
  • Performed using local or regional anesthesia instead of general anesthesia
  • Fewer wound complications after surgery
  • Less bleeding
  • No need to stay in the hospital
  • Less stress on the heart
  • Provides a benefit for those at high risk of complications

Endovascular Surgery vs. Vascular Surgery

To get a clear idea of the difference between endovascular surgery and traditional vascular surgery take a look at the chart below, which compares the two procedures when performing an aneurysm repair. 

Endovascular Surgery vs. Open Surgery
Endovascular Surgery Open Surgery
A local or regional anesthesia is used to numb the local area. General anesthesia is administered to induce sleep.
A very small incision is made near each hip (to access the blood vessels).   A large incision is made in the side of the chest or breastbone (for a thoracic aneurysm) to see the aorta in full view.  
A catheter is placed into the blood vessels in the hip and threaded through to the aorta.   The aorta is clamped in an area above and below the aneurysm to stop the bleeding during surgery.  
A special fabric tube called an endovascular graft is inserted through the arteries (inside the catheter) and positioned in the aorta.   Surgery is done to repair the aneurysm in the aortic wall, the aneurysm is removed and replaced by an artificial blood vessel (a man-made tube comprised of synthetic material).  
The graft expands and seals off the weakened area in the aortic wall (preventing serious complications).   Once the aneurysm is repaired the clamps are removed so blood can resume flowing through the aorta and the incision is sutured or stapled closed.
The graft remains in place, permanently.   The surgeon will remove the sutures approximately 5 to 10 days after surgery.  
The recovery period is quick, and you may resume normal activities in as little as one to two weeks. Full recovery is usually up to 4 weeks.   The patient is hospitalized for up to 10 days (if there are no complications, and there is a very long recovery period of two to three months, in which normal activity may be restricted for as long as six weeks).  

Qualifying for Endovascular Surgery

Once you compare endovascular surgery and open surgery, you may wonder why open surgery is used at all. There are patient- and procedure-specific differences that drive the decision to perform one or the other. Not all procedures can be safely and effectively approached using an endovascular technique. These include:

  • Areas that flex (knees and hips)
  • The shape and location of the aneurysm
  • The blockage may be too extensive
  • Open surgical repair may last longer, which is better for younger people
  • People may not like the lifelong surveillance that follows endovascular surgery

Complications

Just as with any other type of surgery, endovascular procedures pose a risk of potential complications, these include:

  • Infection
  • Blockage of blood flow through the stented vessel
  • Stent fracturing
  • Blood leakage around the vessel
  • Restenosis

Rare Complications

Some serious complications could occur after endovascular surgery, but these are rare, they include:

  • A ruptured or burst artery
  • Blocked blood flow to an area of the body
  • Kidney damage
  • Paralysis

A Word From VeryWell

One thing to keep in mind after endovascular surgery is to be sure to inform your dentist or other healthcare providers that you have a graft so they can take this into consideration for your care. You may be prescribed antibiotics before having certain procedures—such as dental surgery—to prevent infection.

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Article Sources
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  1. UT Southwestern Medical Center. Endovascular Surgery.

  2. National Library of Health (InformedHealth.org). When is surgery recommended for the treatment of abdominal aortic aneurysm? Updated June 14, 2017.

  3. UCSF Health. Endovascular surgery.

  4. UOFM Health. Open repair surgery for abdominal aortic aneurysm. Updated July 14, 2019.