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Private EVAR in the UK, by a consultant vascular surgeon.

A proper endovascular aortic aneurysm repair - with a consultant vascular surgeon, a hybrid theatre, and open repair honestly on the table alongside EVAR per NICE NG156.

A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What a private EVAR costs in the UK.

Indicative ranges across our partner vascular units.

In short

£18,000–£28,000, home in 1–2 nights.

Procedure Indicative range
Standard infrarenal EVAR £18,000–£28,000
Complex EVAR (fenestrated / branched) £35,000–£65,000
TEVAR (thoracic endovascular repair) £25,000–£45,000
Iliac branch device (aorto-iliac) £22,000–£32,000
Open infrarenal AAA repair £20,000–£30,000
Vascular consultation + CT aortogram £800–£1,600

Prices vary by unit, by graft platform (Endurant, Excluder, Zenith, Ovation, AFX), by anatomic complexity and by anaesthetic. Complex fenestrated or branched cases require a custom graft with a 6–12 week lead time.

The problem

The right surgeon, the right procedure, an honest comparison.

EVAR is often sold as the obvious modern option. NICE disagrees for many infrarenal cases. We show you the trade-offs before you commit - including the long-term reintervention and rupture data.

  • Screening result - now what?

    An AAA picked up on NHS screening does not always need surgery. Below-threshold aneurysms are watched, not stented.

  • EVAR or open?

    NICE NG156 recommends open for many infrarenal AAAs. EVAR has lower short-term risk but more late reinterventions. Your call, informed properly.

  • Complex aneurysms handled

    Juxtarenal, thoraco-abdominal and iliac branch cases go to units that actually do the volume. Not every hospital should.

When it helps

When aortic aneurysm repair is the right step.

The indications we see most, plus the one red flag that means an emergency vascular centre rather than a private booking.

  • Infrarenal AAA ≥ 5.5 cm (men)

    The UK surgical threshold for elective repair in men, per NICE NG156 and NHS AAA screening pathway.

  • Infrarenal AAA ≥ 5.0 cm (women)

    The lower threshold used for women, reflecting smaller baseline aortic diameter and higher rupture risk per unit size.

  • Rapid expansion (> 1 cm per year)

    Growth faster than a centimetre a year is a repair indication even below the size threshold.

  • Symptomatic aneurysm

    Back pain, abdominal pain or tenderness over the aneurysm is a urgent repair indication regardless of size.

  • Juxtarenal or thoraco-abdominal

    Aneurysms involving the renal or visceral arteries - repaired with fenestrated or branched EVAR (F/BEVAR) in specialist centres.

  • Descending thoracic aneurysm

    Aneurysms of the thoracic aorta treated with TEVAR - a related endovascular technique with its own risk profile.

  • Aorto-iliac disease

    Aneurysms extending into the iliac arteries - treated with iliac branch devices to preserve internal iliac flow.

  • Red flag: rupture or dissection

    Sudden severe back or abdominal pain, collapse or shock is an emergency - 999 to an emergency vascular centre, not a private booking.

Procedure options

EVAR is not the only option.

What each option on the table actually involves - and which fits which anatomy.

  • Standard infrarenal EVAR

    The commonest procedure - a bifurcated stent-graft deployed via both femoral arteries to seal an infrarenal AAA below the renal arteries.

  • Fenestrated EVAR (FEVAR)

    Custom-made grafts with holes aligned to the renal and visceral arteries - used for juxtarenal aneurysms with a short proximal neck.

  • Branched EVAR (BEVAR)

    Grafts with side branches to the visceral vessels - used for thoraco-abdominal (Crawford) aneurysms in specialist units.

  • TEVAR (thoracic aortic repair)

    Endovascular repair of the descending thoracic aorta for aneurysm, dissection or traumatic transection.

  • Iliac branch device

    A dedicated branch preserves flow to the internal iliac artery when the aneurysm extends into the common iliac.

  • Open surgical repair

    A laparotomy, aortic cross-clamp and Dacron graft - more durable, higher perioperative morbidity. NICE-preferred for many infrarenal cases.

  • Percutaneous vs cutdown access

    Femoral access is achieved either with a suture-mediated closure device (ProGlide) or a small surgical cutdown - chosen by anatomy.

  • Surveillance only

    Aneurysms below threshold are monitored with 3–12 monthly ultrasound or CT until they grow or become symptomatic.

Safety and surveillance

What to expect afterwards - honestly.

EVAR has low perioperative morbidity but comes with a lifelong surveillance commitment and a real rate of secondary intervention. Open repair reverses that trade-off.

  • GA, regional or local all offered

    Most EVARs are done under GA, but regional or local with sedation is available for high-risk patients.

  • Endoleak - the defining EVAR issue

    Type I (proximal or distal seal) needs urgent treatment. Type II (backfill from IMA or lumbars) is the commonest and usually watched. Types III–V are less common.

  • Lifelong CT and ultrasound surveillance

    CT at 30 days, then annual imaging tapering to biennial ultrasound if the sac shrinks. Missed surveillance is the biggest avoidable risk.

  • Secondary interventions are common

    Around 5–10% of patients need a further procedure at 5 years for endoleak, limb occlusion or graft migration.

  • Renal impairment risk

    Contrast load and suprarenal fixation can worsen kidney function - pre-hydration and renal protection are used routinely.

  • Spinal cord ischaemia in thoraco-abdominal

    A specific risk of TEVAR and BEVAR - CSF drainage and permissive hypertension protocols reduce, but do not eliminate, it.

  • Colonic ischaemia and sexual dysfunction

    Rare but recognised - related to covering the IMA and internal iliac arteries. Discussed openly before consent.

  • Groin complications

    Femoral pseudoaneurysm, lymphocoele, haematoma and wound infection are the commonest early problems.

  • Red flags after discharge

    Sudden back or abdominal pain, groin swelling, fever or leg ischaemia after EVAR are not normal - call the vascular team or 999 the same day.

Reading your operation note

Your EVAR note in four parts. Read the last one first.

Whichever graft and technique was used, the note the vascular surgeon sends you keeps to the same shape.

A UK consultant vascular surgeon reviewing an aortogram and operation note

A quiet reminder

Surgical language is precise and can read coldly - we translate it for you.

If you would like us to talk you through the note and the 30-day CT before your review, just ask.

  1. 01 Header

    Indication and graft chosen

    Why the repair was done - size, growth, symptoms - and which platform was used (Endurant, Excluder, Zenith, Ovation, AFX).

  2. 02 Technique

    Access, deployment and completion

    Percutaneous vs cutdown femoral access, deployment sequence, adjunctive procedures (cuff, iliac limb extension) and completion angiogram findings.

  3. 03 Findings

    Endoleak status and sac dynamics

    Any type I–V endoleak at completion, sac diameter baseline, and plan for the 30-day CT.

  4. 04 Impression

    Surveillance schedule and red flags

    Read this first: your CT and ultrasound dates, medication changes, and what symptoms mean you call the vascular team the same day.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

EVAR and open aortic repair are generally covered by UK health insurers when clinically indicated.

Frequently asked

Everything we get asked about EVAR.

Quick answers on NHS screening, NICE guidance, anatomic suitability, endoleaks and long-term surveillance.

  • What is EVAR and how is it different from open repair?

    EVAR (endovascular aortic aneurysm repair) is a keyhole procedure in which a stent-graft is deployed inside the aneurysm through both groins, sealing it from the inside. Open repair is a laparotomy with a cross-clamp and a Dacron graft sewn in. EVAR has lower perioperative risk; open repair is more durable long term.

  • Why does NICE recommend open repair over EVAR for most infrarenal AAAs?

    NICE NG156 (2020) concluded that EVAR has a higher rate of long-term reintervention and late rupture than open repair, and that overall survival is equivalent by 8 years (UK EVAR-1 and EVAR-2 trials). It is contentious - many vascular units still offer both. We help you weigh the evidence for your case.

  • Am I anatomically suitable for EVAR?

    Suitability depends on a proximal aortic neck of at least 10–15 mm, a neck angle under 60°, and iliac access vessels of at least 6–7 mm. A dedicated CT aortogram answers this before you decide.

  • How much does a private EVAR cost in the UK?

    Roughly £18,000–£28,000 for standard infrarenal EVAR, £35,000–£65,000 for complex fenestrated or branched EVAR, and £25,000–£45,000 for TEVAR. A vascular consultation with a planning CT is £800–£1,600.

  • What is the NHS AAA screening programme?

    Since 2013 the NHS invites all men in England for a one-time abdominal ultrasound in the year they turn 65. Aneurysms are then monitored or referred for repair based on size and growth. Women are not routinely screened.

  • What is an endoleak?

    Persistent blood flow into the aneurysm sac around the graft. Type I is a proximal or distal seal failure - needs urgent treatment. Type II is backfill from lumbar arteries or the IMA - the commonest, often watched. Types III (fabric fatigue), IV (porosity) and V (endotension) are less common.

  • Why do I need lifelong scans after EVAR?

    Because endoleaks and graft migration can develop years later and cause late rupture - around 1–2% per year cumulatively. Annual CT or duplex ultrasound catches problems early. Missing surveillance is the single biggest avoidable EVAR risk.

  • When should I go to A&E urgently?

    Sudden severe back or abdominal pain, collapse, groin swelling after EVAR, sudden leg pain or coldness, or fever with new pain are all reasons to call 999 or attend the nearest emergency department the same day.

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