Endovaskular

Endovaskular, or endovascular in English, refers to medical procedures performed within the vascular system using percutaneous access and intravascular devices. The goal is to treat vascular disease without open surgical exposure, often resulting in less trauma, shorter recovery times, and the possibility of treating patients who are high-risk for traditional surgery. The term endovaskular is used in some languages to describe the same approaches.

Common endovascular techniques include balloon angioplasty to dilate narrowed arteries, stent placement to scaffold a vessel, and the use of stent grafts to exclude aneurysms. Other therapies involve atherectomy to remove plaque, thrombolysis or thrombectomy to clear clots, embolization to halt abnormal blood flow, and various imaging-guided interventions such as intravascular ultrasound. Specialized applications include endovascular aneurysm repair (EVAR) and thoracic endovascular aortic repair (TEVAR) for aneurysm management, as well as carotid or renal artery stenting for cerebrovascular or renal ischemia, respectively. Procedures are typically performed via femoral artery access, with radial or brachial approaches used in selected cases.

Indications include peripheral arterial disease, aneurysmal disease, traumatic vascular injury, bleeding control, and certain vascular malformations. Endovascular approaches are often chosen for patients at higher risk from open surgery or when lesions are difficult to access surgically. Benefits commonly include shorter hospital stays and quicker recovery, though durability varies by condition and patient factors. Long-term follow-up with imaging is usually required to monitor patency and repair integrity.

Risks include vascular access complications, contrast-induced nephropathy, stroke, myocardial infarction, graft or stent occlusion, restenosis, and radiation exposure. The field is practiced by interventional radiologists, vascular surgeons, and interventional cardiologists in multidisciplinary vascular centers, with ongoing advances in devices, imaging, and techniques.