The Current Status of Endovascular Repair of Abdominal Aortic Aneurysms (EVAR)

Abdominal aortic aneurysms (AAA) affect close to a quarter of a million people in the United States every year. Intervention is designed to treat the AAA when the patient becomes symptomatic and to prevent the fatality associated with rupture. Physicians and patients should weigh the risks associated with intervention compared to the risk of rupture for the particular size of the aneurysm and the patient’s comorbidities. Thus, the decision to intervene, especially in asymptomatic aneurysms, is mostly based on clinical judgment. Endovascular AAA repair (EVAR) is attractive in that it offers a minimally invasive approach that obviates a major abdominal procedure and cross-clamping of the aorta. We report on the current affairs of the major clinical trials evaluating the outcomes of patients undergoing EVAR and describe the current devices available in the United States for endovascular repair.