While endovascular aneurysm repair (EVAR) of aortic aneurysm has expanded over the last 20 years, there are still cases where this minimally invasive procedure has limitations. Using a new type of endograft called fenestrated endografts, surgeons at Norton Heart & Vascular Institute are repairing abdominal aortic aneurysms (AAAs) that are close to the renal or other visceral arteries and preclude use of a traditional endograft.

Patients with AAAs close to the visceral arteries had required open surgery in the past to place the grafts without interfering with nearby vessels. The fenestrated endovascular aneurysm repair (FEVAR) is minimally invasive, like the traditional EVAR, but allows for preservation of the visceral and renal arteries.

“Fenestrated endografts allow us to expand the use of less invasive endografts for treatment of complicated aortic aneurysms while maintaining blood flow to the visceral arteries” said Gregory C. Schmieder, M.D., vascular surgeon with Norton Heart & Vascular Institute. “Patients typically go home in a few days without the lengthy recovery that follows open AAA surgery.”

There are also branched iliac endografts which help preserve pelvic blood flow in the setting of iliac artery aneurysms. There are about 5% to 10% of patients who may need a fenestrated or iliac branched endograft. These new additions have allowed us to expand our treatment of complex aortic and iliac artery aneurysms.