endografts

Endografts are medical devices used in endovascular surgery to treat arterial diseases by excluding the diseased segment from blood flow. They consist of a stent framework covered by a fabric graft and are delivered to the site through catheters, most often via the femoral arteries, under fluoroscopic guidance. Once deployed, the graft lines the vessel wall and provides a new, continuous lumen that preserves distal blood flow while preventing pressurized blood from entering an aneurysm sac or injured segment.

The device combines a metallic stent, which provides structural support, with a biocompatible graft material such as expanded polytetrafluoroethylene (ePTFE) or Dacron (polyester). Stents may be self-expanding or balloon-expandable, and many endografts are modular, offering proximal and distal sealing zones and components that can be configured for bifurcated, straight, fenestrated, or branched designs to accommodate anatomy and branch vessels.

Indications include abdominal aortic aneurysm repair (EVAR), thoracic aortic aneurysm repair (TEVAR), and other arterial pathologies such as dissections, traumatic injuries, or peripheral aneurysms. Planning relies on detailed imaging to assess aortic or arterial anatomy, including neck length, angulation, and branch vessel needs. The procedure is typically performed under anesthesia in a hybrid operating room or catheterization lab.

Benefits compared with open repair include reduced perioperative morbidity and shorter hospital stay, especially in appropriately selected patients. However, lifelong surveillance with imaging is required to monitor for endoleaks, graft migration or fracture, and other device-related complications. Endografts have evolved to accommodate complex anatomies with advanced fenestrated and branched designs, expanding indications and improving durability.