The SECOND technique (endovascular aneurysm repair or EVAR) involves implantation of a covered stent from within the aneurysm sac to exclude blood flow and pressure from the AA thereby reducing tension on the weakened wall and greatly minimizing the risk of rupture.
This technique is minimally invasive and is now used in 70% or more of patients with abdominal, thoracic and thoraco-abdominal aneurysms. The stents are inserted into the aneurysm sac by special catheters that are guided with X ray imaging. Minimal incisions are sometimes needed in the upper thigh region to introduce the stent graft.
Endovascular repair requires precise size planning to ensure complete exclusion of the AA and associated iliac aneurysms if present.
Endovascular stent graft technology has seen tremendous technologic advances in the last decade. Currently stent grafts can be tailored treat AA involving aortic segments with vital branches to the liver, gut and kidneys branches.
The stent graft procedure can be performed under local, spinal or general anesthesia.
Patients who undergo endovascular repair need serial long term follow up with CT or Ultrasound to detect any serious leaks around the stent back into AA as this occurs in 5% of patients