The Region’s Most Comprehensive Aneurysm Treatment Program

Western Surgical Group offers the full spectrum of aneurysm repair options — from standard procedures to the most complex interventions available anywhere in Northern Nevada. We are the region’s exclusive provider of Fenestrated Endovascular Aneurysm Repair (FEVAR), performed by surgeons formally trained by world-leading experts.

Conditions We Treat:

  • Abdominal Aortic Aneurysm (AAA)
  • Thoracic Aortic Aneurysm
  • Complex aortic aneurysms involving branch vessels

What Is an Aortic Aneurysm?

An aortic aneurysm is a bulge or weakening in the wall of the aorta — the body’s largest artery, which carries oxygen-rich blood from the heart to the rest of the body. As the aneurysm grows, the artery wall becomes thinner and weaker, increasing the risk of rupture. A ruptured aortic aneurysm is a life-threatening emergency with high mortality rates.

Types of Aortic Aneurysms:

Abdominal Aortic Aneurysm (AAA) — occurs in the section of the aorta that passes through the abdomen. Most common type of aortic aneurysm.

Thoracic Aortic Aneurysm — occurs in the section of the aorta that passes through the chest. Less common but equally serious.

Risk Factors:

  • Age (over 60)
  • Male gender
  • Smoking (most significant modifiable risk factor)
  • High blood pressure
  • Family history of aneurysms
  • Atherosclerosis (hardening of the arteries)
  • Genetic conditions affecting connective tissue

Symptoms:

Many aneurysms cause no symptoms until they rupture. When symptoms do occur, they may include:

  • Deep, constant pain in the abdomen or back
  • Pulsating sensation in the abdomen
  • Difficulty swallowing or breathing (thoracic aneurysms)

When rupture occurs:

  • Sudden, severe pain in the abdomen, back, or chest
  • Rapid heart rate
  • Loss of consciousness
  • Signs of shock

A ruptured aneurysm requires immediate emergency surgery.

Our Aneurysm Repair Options

1. Endovascular Aneurysm Repair (EVAR)

Minimally Invasive Repair for Abdominal Aortic Aneurysms

EVAR is a minimally invasive procedure to repair an abdominal aortic aneurysm without the need for a large abdominal incision.

How It Works:

Small incisions are made in the groin to access the femoral arteries. Using advanced imaging guidance, the surgeon threads a catheter containing a collapsed stent-graft up to the aneurysm. The stent-graft is positioned across the aneurysm and expanded, creating a new pathway for blood flow and excluding the weakened aneurysm sac from pressure. This prevents the aneurysm from growing or rupturing.

Advantages:

  • Minimally invasive approach
  • Faster recovery than open surgery
  • Shorter hospital stay (typically 1-2 days)
  • Less post-operative pain
  • Lower risk of complications in many patients

Best For:

  • Patients with appropriate anatomy
  • Those at higher risk for open surgery
  • Abdominal aortic aneurysms meeting size criteria

2. Thoracic Endovascular Aneurysm Repair (TEVAR)

Minimally Invasive Treatment for Chest Aneurysms

TEVAR uses a similar minimally invasive approach to treat aneurysms in the thoracic (chest) portion of the aorta.

How It Works:

Through small incisions (usually in the groin), a stent-graft is guided through the blood vessels to the thoracic aorta. The device is deployed to seal off the aneurysm, redirecting blood flow through the stent-graft and reducing pressure on the weakened aortic wall.

Advantages:

  • Avoids the need for opening the chest
  • Faster recovery than open thoracic surgery
  • Reduced risk compared to traditional surgery in many cases
  • Can treat aneurysms, dissections, and traumatic aortic injuries

Best For:

  • Thoracic aortic aneurysms
  • Aortic dissections
  • Traumatic aortic injuries
  • Patients with suitable anatomy

3. Fenestrated Endovascular Aneurysm Repair (FEVAR)

The Region’s Only Program for Complex Aneurysm Repair

FEVAR is an advanced endovascular technique for treating complex aortic aneurysms that involve branch vessels — arteries that supply blood to the kidneys, intestines, and other vital organs. This highly specialized procedure is available only at Western Surgical Group in Northern Nevada.

How It Works:

FEVAR uses custom-designed stent-grafts with fenestrations (small openings) and branches that align with the patient’s branch arteries. This allows the surgeon to seal the aneurysm while maintaining blood flow to critical organs. The procedure requires meticulous planning using advanced CT imaging and custom-manufactured devices.

Why FEVAR Is Exceptional:

FEVAR demands the highest level of endovascular skill and specialized training. Our surgeons are formally trained by world-leading experts in this technique, bringing this life-saving option to Northern Nevada patients who would otherwise need to travel out of state for care.

Best For:

  • Complex aneurysms involving branch vessels
  • Aneurysms extending to or above the renal arteries
  • Patients who cannot undergo traditional open surgery
  • Those requiring preservation of blood flow to vital organs

Why Choose Western Surgical Group for Aneurysm Repair?

  • Full spectrum of treatment options — from standard EVAR/TEVAR to complex FEVAR
  • Only FEVAR program in Northern Nevada — eliminating need to travel out of state
  • Surgeons trained by world-leading experts in complex endovascular techniques
  • State-of-the-art hybrid operating rooms with advanced imaging
  • Personalized treatment plans based on anatomy, health status, and goals
  • Comprehensive follow-up care with regular imaging surveillance

When Is Surgery Recommended?

Not all aneurysms require immediate surgery. Your vascular surgeon will recommend treatment based on:

Size:

  • AAA > 5.5 cm in men or > 5.0 cm in women typically warrants repair
  • Thoracic aneurysms > 5.5-6.0 cm generally require treatment
  • Smaller aneurysms may be monitored with regular imaging

Growth Rate:

  • Rapid growth (> 0.5 cm in 6 months) may indicate need for earlier intervention

Symptoms:

  • Any symptomatic aneurysm should be evaluated for repair

Rupture Risk:

  • Certain shapes, locations, and patient factors increase rupture risk

Emergency:

  • Ruptured aneurysms require immediate surgery

Recovery and Long-Term Care

After Endovascular Repair (EVAR/TEVAR/FEVAR):

  • Hospital stay typically 1-3 days
  • Resume light activities within 1-2 weeks
  • Full recovery usually within 2-4 weeks
  • Groin incision care and activity restrictions initially

Long-Term Follow-Up:

All aneurysm repairs require lifelong surveillance with imaging (CT scans or ultrasound) to ensure:

  • The stent-graft remains in proper position
  • The aneurysm is not growing
  • No endoleaks (blood flow around the graft) develop
  • Branch vessel stents remain open (FEVAR patients)

Typical Surveillance Schedule:

  • 1 month after surgery
  • 6 months
  • 12 months
  • Annually thereafter (or as recommended)

Benefits of Endovascular Aneurysm Repair

  • Prevention of life-threatening aneurysm rupture
  • Minimally invasive approach in most cases
  • Faster recovery than open surgery
  • Lower complication rates for many patients
  • Ability to treat complex aneurysms with FEVAR
  • Reduced hospital stay and recovery time

Risks and Considerations

While endovascular aneurysm repair has excellent outcomes, potential risks include:

  • Endoleak (blood flow into aneurysm sac)
  • Stent-graft migration or malfunction
  • Branch vessel complications (especially with FEVAR)
  • Kidney injury from contrast dye
  • Access vessel injury
  • Infection
  • Need for future interventions

Open surgical repair remains an option for patients who are not candidates for endovascular treatment or prefer traditional surgery. Your surgeon will discuss all options with you.

Divisions Involved in Your Care

Diagnoses We Treat

Frequently Asked Questions

Many aneurysms are discovered incidentally on imaging done for other reasons (CT scan, ultrasound). Screening is recommended for men over 65 who have ever smoked, and for anyone with a family history of aneurysms. Talk to your doctor about whether screening is appropriate for you.

General guidelines suggest repair when AAA reaches 5.5 cm in men or 5.0 cm in women, or when thoracic aneurysms reach 5.5-6.0 cm. However, factors like growth rate, symptoms, aneurysm shape, and individual risk factors also influence the decision. Your surgeon will create a personalized treatment plan.

Modern stent-grafts are designed to be permanent and durable. Most function well for many years. However, long-term surveillance is essential to detect and address any issues early. Some patients may need additional procedures over time.

An endoleak occurs when blood continues to flow into the aneurysm sac around or through the stent-graft. Some endoleaks seal on their own; others require treatment to prevent aneurysm growth. This is why regular follow-up imaging is crucial.

FEVAR is used for complex aneurysms that involve branch vessels supplying the kidneys and intestines. Your vascular surgeon will review your CT imaging to determine if your anatomy is suitable for FEVAR and whether it's the best option for you.

You'll have regular imaging (usually ultrasound or CT scan) every 6-12 months to monitor the aneurysm size. Your doctor will also work with you to manage risk factors like blood pressure, cholesterol, and smoking cessation to slow aneurysm growth.

Yes. One of the major advantages of endovascular repair is that it avoids the need to enter the abdomen, making it ideal for patients with previous abdominal surgeries or conditions that make open surgery higher risk.

FEVAR is one of the most technically demanding endovascular procedures in vascular surgery. It requires specialized training from world-leading experts, custom-manufactured devices, advanced imaging capabilities, and extensive experience. Our surgeons have invested in this training to bring this life-saving option to our community.