Endovascular Repair of Abdominal Aortic Aneurysm (EVAR)

Safe, advanced, and minimally invasive care at Jordan Vascular Clinic

An abdominal aortic aneurysm (AAA) is a bulge or “ballooning” in the main artery in your abdomen. If it grows, it can tear or rupture. The good news: most AAAs can be treated safely before they cause trouble. This page explains who needs treatment, how EVAR works, what to expect before and after the procedure, and why our team is a regional leader in advanced endovascular care.

What is EVAR?

EVAR (Endovascular Aneurysm Repair) fixes the weak part of the aorta from the inside using a fabric-covered metal tube called a stent‑graft. Through tiny openings at the top of the legs (groins), we guide the stent‑graft into place and seal off the aneurysm. Blood then flows through the stent‑graft instead of the aneurysm, lowering the risk of rupture.

Why patients like EVAR

• Small incisions, less pain

• Usually a 1–2 day hospital stay

• Faster return to normal activity compared with open surgery

In some cases, open surgery may still be the best or safest option. We discuss all choices with you.

Who should consider repair?

Your need for repair depends on aneurysm size, growth speed, shape, and whether you have symptoms.

Common reasons to treat include:

• Large size (often around 5.0–5.5 cm, with lower thresholds for some patients)

• Fast growth (for example, a large jump in size within a year)

• Symptoms like new belly or back pain related to the aneurysm

• Aneurysms in the iliac arteries (the branches to the pelvis) that meet repair criteria

We confirm details with high‑quality ultrasound and CT scans, then create a personalized plan.

Advanced EVAR options we offer

Every aorta is different. We provide a full toolbox of modern techniques so more people can benefit from minimally invasive repair:

1) Standard EVAR

For aneurysms with suitable “landing zones” in the aorta and iliac arteries.

2) Fenestrated & Branched EVAR (FEVAR/BEVAR)

Custom openings or branches in the stent‑graft keep blood flowing to vital arteries (kidneys, gut, pelvis) while sealing the aneurysm. This helps treat more complex or short‑neck aneurysms without open surgery.

3) Iliac Branch Endoprosthesis (IBE)

When the aneurysm extends into the iliac arteries, an IBE allows us to preserve the internal iliac (hypogastric) artery to reduce buttock claudication and pelvic ischemia.

4) Percutaneous EVAR (PEVAR)

We use tiny needle punctures with closure devices rather than surgical groin cuts whenever appropriate—less pain, faster recovery.

5) Image‑Guided Precision

• 3D fusion imaging and road‑mapping to reduce contrast dye and X‑ray exposure.

• Intravascular ultrasound (IVUS) for real‑time sizing and seal confirmation.

• CO₂‑assisted angiography where helpful to protect the kidneys.

6) Endoleak Management & Re‑intervention

If a small leak of blood reaches the aneurysm sac after EVAR, we have minimally invasive options: targeted embolization, relining, cuffs, or branch work depending on the cause (Type I–V). Most issues are handled through tiny punctures without open surgery.

Your EVAR journey, step by step

Before the procedure

• Pre‑assessment: medical history, labs, kidney function, and imaging.

• Optimize risk factors: blood pressure, cholesterol, blood sugar, and smoking cessation. We typically use statins and antiplatelet therapy unless there’s a reason not to.

• Anesthesia plan: most EVARs are done with local anesthesia and light sedation; some need general anesthesia.

Day of EVAR

1. Tiny groin punctures (or small incisions if needed)

2. X‑ray guidance to position the stent‑graft

3. Seal the aneurysm; check blood flow to the kidneys, intestines, and legs

4. Close the punctures; most patients walk the same day

Recovery

• Most patients go home in 24–48 hours

• Back to light activity in a few days; normal activity usually within 1–2 weeks (your plan may vary)

Follow‑up after EVAR

Lifelong follow‑up is important to keep you safe. We use a tailored surveillance plan that often starts with a CT scan early on, then relies more on ultrasound (no radiation) when the repair is stable and the aneurysm sac is shrinking. If anything changes, we act early and minimally invasively.

Risks we watch for (and how we prevent them)

• Endoleak: treated with targeted endovascular fixes

• Groin issues: minimized with percutaneous techniques

• Kidney strain from contrast: preventive hydration, kidney‑safe protocols, and low‑contrast/IVUS/CO₂ strategies

• Device movement or narrowing: corrected with cuffs or relining if needed

Your team will explain your personal risk profile and our prevention plan.

Why choose Dr. Omar Hamdallah & Jordan Vascular Clinic

• Regional expertise: High‑volume endovascular practice with advanced FEVAR/BEVAR planning and iliac branch solutions

• Safety first: Low‑contrast and radiation‑sparing protocols; percutaneous access when appropriate

• Team approach: Coordination with cardiology, anesthesia, nephrology, and radiology for complex cases

• Personalized care: Clear explanations, shared decision‑making, and 24/7 access for urgent concerns

Frequently asked questions

Is EVAR painful? Most patients report mild discomfort managed with tablets.

How long will the stent‑graft last? Modern devices are designed for long‑term durability. That’s why we keep up with regular scans to ensure everything stays perfect.

Can I travel after EVAR? Usually within a few weeks once your doctor clears you. We’ll give you a travel letter and device details.

What if my anatomy is not ideal for standard EVAR? We often have fenestrated/branched options or open surgery when that’s safest.

Book a consultation

If you or a loved one has an abdominal aortic aneurysm—or you’ve been told you’re a candidate for EVAR—contact Jordan Vascular Clinic in Amman to review your imaging and discuss the best, safest plan tailored to you.

This page is educational and not a substitute for medical advice. Your treatment plan will be individualized after a full assessment.