AAA repair - endovascular - discharge; Repair - aortic aneurysm - endovascular - discharge; EVAR - discharge; Endovascular aneurysm repair - discharge

You had endovascular aortic surgery repair to repair an aneurysm (a widened part) in your aorta, the large artery that carries blood to your belly (abdomen), pelvis, and legs.

Your doctor made a small incision (cut) near your groin to find your femoral artery. Then your doctor inserted a stent and a manmade (synthetic) graft through the incision into the artery. The doctor used x-rays to guide the stent and graft up into your aorta where the aneurysm was located. The graft and stent were then opened up and attached to the walls of the aorta.

If the doctor put a catheter in through your groin to place the graft:

• You can walk short distances on a flat surface. Limit going up and downstairs to around 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 doctor tells you to wait.

You will need to take care of your incision.

• Your doctor or nurse will tell you how often to change your dressing.
• If your incision bleeds or swells up, lie down and put pressure on it for 30 minutes.

Walk short distances 3 to 4 times a day. Slowly increase how far you walk each time. When you are not walking, try to keep your legs higher than the level of your heart.

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

Your doctor may ask you to take aspirin or another medicine called clopidogrel (Plavix) when you go home. These medicines are blood thinners. They keep your blood from forming clots in your arteries or stent. Do not stop taking them without talking with your doctor first.

See also:

• Clopidogrel (Plavix)
• Aspirin and heart disease

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, exercise, stop smoking (if you smoke), and reduce stress to help lower your chances of having a blocked artery again.
• Your health care provider may give you medicine to help lower your cholesterol. See also: Cholesterol - drug treatment
• If you were given medicines for blood pressure or diabetes, take them as your doctor has asked you to.

Call your doctor or nurse 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 over 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, or yellow or green discharge is draining from it.
• 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.
• You have blood in your stools.
• You are not able to move your legs.
• If your belly starts to swell and is painful.

De Bruin JL, Baas AF, Buth J, Prinssen M, Verhoeven EL, Cuypers PW, van Sambeek MR, Balm R, Grobbee DE, Blankensteijn JD; DREAM Study Group. Long-term outcome of open or endovascular repair of abdominal aortic aneurysm. N Engl J Med. 2010 May 20;362(20):1881-9.

Gloviczki P, Ricotta JJ II. Aneurysmal vascular disease. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 65.

Greenhalgh RM, Powell JT. Endovascular repair of abdominal aortic aneurysm. N Engl J Med. 2008 Jan 31;358(5):494-501.

Lederle FA, Kane RL, MacDonald R, Wilt TJ. Systematic review: repair of unruptured abdominal aortic aneurysm. Ann Intern Med. 2007 May 15;146(10):735-41.