What is Endovascular Surgery?

A Modern, Minimally Invasive Approach to Vascular Treatment

Endovascular surgery is a leading advancement in vascular medicine, offering treatment for artery and vein diseases from inside the blood vessel. Rather than making large incisions, specialists insert thin catheters through tiny punctures (often in the groin or wrist) to repair, unblock, or strengthen blood vessels using live imaging.

This innovative approach delivers effective results with less pain, faster recovery, and fewer risks compared to traditional open surgery. Recent data shows endovascular procedures now account for over 80% of aortic aneurysm repairs, with technical success rates consistently exceeding 95%.

Understanding Endovascular Surgery

Endovascular means “inside the vessel.” Unlike open surgery, which requires cutting the body to access the artery or vein, endovascular surgery uses imaging techniques such as X-ray, ultrasound, or CT. It then guides the surgeon through the blood vessels.

Our vascular surgeons carry out these procedures in specialized endovascular suites that have cutting-edge imaging technology for precision and maximum patient comfort and safety.

The most common conditions treated with endovascular surgery include:

• Peripheral Artery Disease 
• Aortic Aneurysms 
• Carotid Artery Disease 
• Arterial and venous Blood Clots 
• Dialysis access issues 

Common Endovascular Surgery Procedures

Endovascular surgery includes multiple treatment options, each designed to prevent complications and ensure normal blood flow.

1. Angioplasty and Stenting

To open a narrowed artery, surgeons first position a small balloon in it and inflate it. Sometimes, an artery-keeping stent is placed to enhance blood flow after a peripheral artery disease. Angioplasties have immediate blood flow restoration success rates exceeding 90%.

2. Endovascular Aneurysm Repair (EVAR / TEVAR)

To treat aortic aneurysms, a stent-graft is placed and the aneurysm is removed. This is done through a small incision to prevent rupture of the aorta. Studies show EVAR procedures offer 30-day mortality rates of 1.6% compared to 4.8% for open surgery.

3. Catheter-Directed Thrombolysis and Thrombectomy  

These minimally invasive techniques restore blood flow and tissue health by dissolving or removing blood clots.

4. Carotid Artery Stenting  

Endovascular stenting offers a less invasive way to treat carotid artery disease in the neck, helping patients avoid open surgery while improving blood flow.

5. Dialysis Access Interventions  

Endovascular treatment for dialysis plays a vital role in keeping dialysis grafts and fistulas functional, supporting effective ongoing dialysis therapy.

6. Embolisation Procedures  

These are performed to stop the flow of blood through abnormal or excessive bleeding vessels. This is used in the treatment of aneurysms and in the treatment of vascular malformations.  

Benefits of Endovascular Surgery

Patients and doctors increasingly prefer endovascular treatment for its effectiveness and comfort. Here’s why:

Minimally invasive: Procedures that are performed with no cuts and with minimal invasiveness are less painful with smaller recovery times. Most patients undergoing these techniques remain conscious.  

Short hospital stay: The amount of time in the hospital is decreased with many patients undergoing outpatient procedures and only a single overnight stay.  

Faster recovery: Patients can recover much more quickly and get back to their daily activities in a matter of days.  

Lower complication risk: Patients are much less likely to suffer from bleeding and severe open wound complications in comparison to open surgery.

This is perfect for those who aren’t able to handle open surgery due to their age or other reasons. Research states that even those patients who are older than 80 years achieve success rates above 90%.

For these reasons, endovascular surgery is now the first option for many vascular conditions.

Who Can Benefit from Endovascular Treatment?

Patients with the following conditions are the most likely to experience the benefits of endovascular surgery:  

• Peripheral Artery Disease (PAD): Patients experiencing symptoms of PAD, such as leg pain or restricted blood flow, are often recommended as an endovascular procedure as a treatment for PAD.
• Aortic Aneurysm: A blood vessel bulge that, when left untreated, can rupture.  
• Carotid Artery Disease: The arteries to the neck are narrowed, causing a high risk for stroke.  
• Venous Disease: Patients have blood clots or chronic obstruction of the veins.  
• Dialysis Access Problems: Grafts or fistulas that are plugged or malfunctioning.  

Since each case is unique in medicine. That’s why your vascular specialist will perform an ultrasound, CT angiography, or diagnostic angiography to make an informed decision regarding the appropriateness of an endovascular option.  

What to Expect Before, During & After Treatment

Before The Procedure

Before your procedure, your vascular surgeon will review your medical history along with anesthesia options, and then will map the safest access route with imaging tests. These tests sometimes help determine which medications need adjustment or which can be paused.

During the Procedure

The surgeon makes a small incision in the groin or wrist under local anesthesia and mild sedation. Using live X-ray imaging, they guide a catheter to the target blood vessel and perform the treatment, such as angioplasty, stent placement, or graft repair. The procedures are typically 1 to 3 hours.

After the Procedure

The majority of patients are discharged home that same day or after 1 night. 

• Some degree of dull aching or bruising is expected at the puncture site.
• You can return to light activities in a few days. 
• Regular follow-up scans are critical to long-term success.

Risks and Long-Term Outlook

Endovascular procedures are minimally invasive and quite safe, but like all procedures, there are small risks such as the following:  

• Bruise or bleed at the puncture site.  
• Injury to the vessel, re-narrowing of the vessel (re-stenosis)  
• Reactions to contrast dye  
• Infection (rare)  
• A graft can leak (for aneurysm repairs)  

97% of the time, patients will have no ruptured aneurysm after EVAR for 5 years. 

Raising Awareness

Vascular disease is often very quiet and goes unnoticed. If you experience leg pain, wounds that don’t heal, numbness, or swelling, these could be early signs of a circulation problem.

A vascular specialist can evaluate your condition to help prevent serious issues and in many cases, perform endovascular surgery to avoid the need for open surgery.

Don’t put off care. Early diagnosis allows easy treatment and significantly lowers the risks.

Why Choose Prime Vascular Care

At Prime Vascular Care, our board-certified vascular surgeons are trained and will deliver your care with advanced endovascular techniques.

We have advanced endovascular suites that offer diagnosis and treatment in one visit. We emphasize educating our patients, also customizing treatment plans for every patient, and focus on their long-term vascular health.