Recovery after abdominal aortic aneurysm repair: EVAR and open surgery

This page covers the recovery stage of the operation described on the main aneurysm repair guide. It draws on leaflets from Gloucestershire Hospitals and Leeds teaching hospitals, which describe two different operations with very different recoveries, so the table has separate rows.

The leaflets also differ from each other on small points, such as when the first scan is done, because vascular units run their own surveillance. Follow your own unit's plan, which overrides anything here.

After EVAR the leaflet from Gloucestershire describes very small groin wounds, about 0.5 cm, through which the stent graft is passed, although some groin cuts can be slightly larger. Leeds says to report uncontrollable pain, oozing or reddening around a wound, which can signal infection.

After open repair the cut is much larger. Gloucestershire describes a continuous epidural for pain control, followed by regular tablets, clips removed about 10 days after surgery, and a few days before eating and normal bowel movements return. Feeling weak is normal and expected.

The Gloucestershire EVAR leaflet says you can resume driving once you can do an emergency stop without pain or hesitation, and says to build up activity each day. The Gloucestershire open-repair leaflet gives about four weeks for driving once an emergency stop is comfortable. Leeds adds that if you previously surrendered your licence because of the aneurysm you must reapply before driving again. GOV.UK says to tell the DVLA if you have had an operation and cannot drive three months later; it also advises asking your doctor. Tell your insurer about the operation.

Leeds says most people return to work around two weeks after EVAR, though this varies, whereas open surgery means a longer wait. Gloucestershire says to avoid heavy lifting for two months after open repair. Walking is encouraged in both cases, starting with short distances.

Stent grafts need surveillance. Gloucestershire says a CT scan is done before a six-week outpatient visit, an ultrasound follows around six months and then every year, and that follow-up scans are needed for the rest of your life. Leeds says CT is booked about one month after the procedure, with a clinic review about two weeks after the scan, a CT at one year and then annual ultrasound.

The Gloucestershire leaflet says around 15 in 100 patients need further surgery in the first four years after EVAR, such as for an endoleak, which is why the scans matter. Leeds says aspirin and a statin are usually prescribed for life to reduce the risk of clots and arterial disease.

After open repair Gloucestershire gives a follow-up appointment about six weeks after discharge.

• Sudden severe abdominal, back or groin pain, collapse or faintness: call 999.

• A groin or abdominal wound that oozes, reddens or becomes uncontrollably painful: contact the vascular team or GP, as Leeds advises.

• A cold, pale, painful or numb leg: urgent same-day assessment through 999 or A&E.

• Fever, or increasing breathlessness and chest pain: NHS 111 or 999 depending on severity.