Aortic aneurysm repair - endovascular - discharge

  • Alternative Names
    • AAA repair - endovascular - discharge; Repair - aortic aneurysm - endovascular - discharge; EVAR - discharge; Endovascular aneurysm repair - discharge

  • When You're in the Hospital
    • You had endovascular aortic surgery repair for an aneurysm (a widened part) of the large artery that carries blood to your lower body (aorta).

      To perform the procedure:

      • Your doctor made a small incision (cut) near your groin to find your femoral artery.
      • A large tube was inserted into the artery so that other instruments could be inserted.
      • An incision may have been made in the other groin as well as the arm.
      • Your doctor inserted a stent and a man-made (synthetic) graft through the incision into the artery.
      • X-rays were used to guide the stent and graft into your aorta where the aneurysm was located.
      • The graft and stent were opened up and attached to the walls of the aorta.
  • What to Expect at Home
    • The cut in your groin may be sore for several days. You should be able to walk farther now without needing to rest. But you should take it easy at first. It may take 6 to 8 weeks to fully recover. You may feel discomfort in your abdomen for a few days. You may also have a loss of appetite. This will get better over the next week. You may have constipation or diarrhea for a short time.

  • Self-care
    • You will need to increase your activity slowly while the incision heals.

      • Walking short distances on a flat surface is OK. Try to walk a little, 3 or 4 times a day. Slowly increase how far you walk each time.
      • Limit going up and down stairs to about 2 times a day for the first 2 to 3 days after the procedure.
      • DO NOT do yard work, drive, or play sports for at least 2 days, or for the number of days your health care provider tells you to wait.
      • DO NOT lift anything heavier than 10 pounds for 2 weeks after the procedure.
      You will need to take care of your incision.
      • Your provider will tell you how often to change your dressing.
      • If your incision bleeds or swells, lie down and put pressure on it for 30 minutes.

      When you are resting, try keeping your legs raised above the level of your heart. Place pillows or blankets under your legs to raise them.

      Ask your provider about follow-up x-rays you will need to have to check if your new graft is OK.

      Your doctor may ask you to take aspirin or another medicine called clopidogrel (Plavix) when you go home. These medicines are antiplatelet agents. They prevent the platelets in your blood from clumping together and forming clots in your arteries or stent. DO NOT stop taking them without talking with your doctor first.

  • Lifestyle Changes
    • Endovascular surgery does not cure the cause of your aneurysm. Your arteries may become wide again. To prevent the aneurysm from coming back:

      • Eat a heart-healthy diet.
      • Get regular exercise.
      • Stop smoking (if you smoke).
      • Reduce stress to help lower your chances of having a blocked artery again.

      Your provider may give you medicine to help lower your cholesterol. If you are given medicines for blood pressure or diabetes, take them as your doctor has asked you to.

  • When to Call the Doctor
    • Call your provider if:

      • You have pain in your belly or back that does not go away or is very bad.
      • There is bleeding at the catheter insertion site that does not stop when pressure is applied.
      • There is swelling at the catheter site.
      • Your leg or arm below where the catheter was inserted changes color, becomes cool to the touch, pale, or numb.
      • The small incision for your catheter becomes red or painful.
      • Yellow or green discharge is draining from the incision for your catheter.
      • Your legs are swelling.
      • You have chest pain or shortness of breath that does not go away with rest.
      • You have dizziness or fainting, or you are very tired.
      • You are coughing up blood, or yellow or green mucus.
      • You have chills or a fever over 101°F (38.3°C).
      • You have blood in your stool.
      • Your urine becomes dark colored or you do not urinate as much as usual.
      • You are not able to move your legs.
      • Your belly starts to swell and is painful.
  • References
    • De Bruin JL, Baas AF, Buth J, et al. Long-term outcome of open or endovascular repair of abdominal aortic aneurysm. N Engl J Med. 2010;362(20):1881-1889. PMID: 20484396

      Fahad S, Kwolek CJ. Endovascular treatment of abdominal aortic aneurysm. In: Cameron JL, Cameron AM, eds. Current Surgical Therapy. 11th ed. Philadelphia, PA: Elsevier Saunders; 2014:783-787.

      Hammond CJ, Nicholson AA. Aortic intervention. In: Adam A, Dixon AK, Gillard JH, Schaefer-Prokop CM, eds. Grainger & Allison's Diagnostic Radiology: A Textbook of Medical Imaging. 6th ed. New York, NY: Elsevier Churchill Livingstone; 2015:chap 85.

      Sternbergh WC. Technique: Endovascular aneurysm repair. In: Cronenwett JL, Johnston W, eds. Rutherford's Vascular Surgery. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 90.

      Tracci MC, Cherry KJ. The aorta. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 20th ed. Philadelphia, PA: Elsevier Saunders; 2017:chap 61.