Concierge vascular surgery · UK
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.
Why patients choose us
- 01
A vascular surgeon, in a hybrid theatre
Not a screening desk and not a general clinic. A named consultant vascular surgeon, a hybrid imaging theatre, and the anaesthetic that suits you.
- 02
Open repair honestly on the table
NICE NG156 recommends open repair over EVAR for many infrarenal AAAs. We say so before you commit to a stent-graft.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What a private EVAR costs in the UK.
Indicative ranges across our partner vascular units. Send the CT and we quote firm figures across EVAR, complex EVAR and open repair.
In short
Standard infrarenal EVAR in our network: £18,000–£28,000, home in 1–2 nights.
| Procedure | Indicative range | Typical duration | Admission |
|---|---|---|---|
| Standard infrarenal EVAR | £18,000–£28,000 | 2–3 hr | 1–2 nights |
| Complex EVAR (fenestrated / branched) | £35,000–£65,000 | 4–6 hr | 3–5 nights |
| TEVAR (thoracic endovascular repair) | £25,000–£45,000 | 2–4 hr | 2–4 nights |
| Iliac branch device (aorto-iliac) | £22,000–£32,000 | 3–4 hr | 2 nights |
| Open infrarenal AAA repair | £20,000–£30,000 | 3–5 hr | 5–8 nights |
| Vascular consultation + CT aortogram | £800–£1,600 | 60 min | Same visit |
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. We come back with a firm quote within one working day.
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.
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Screening result — now what?
An AAA picked up on NHS screening does not always need surgery. Below-threshold aneurysms are watched, not stented.
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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.
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Complex aneurysms handled
Juxtarenal, thoraco-abdominal and iliac branch cases go to units that actually do the volume. Not every hospital should.
The journey
From enquiry to lifelong surveillance — what happens, in order.
One vascular team from first message through CT planning to the 30-day scan and beyond.
Phase 1 · Before your procedure
Concierge, off-stage for you
Phase 2 · Admission
A day in the hybrid theatre
Phase 3 · After
Lifelong surveillance
- 01
Before
You tell us what is going on
A short, confidential form. NHS screening result, scan findings, aneurysm size, any symptoms, other medical conditions.
- 02
Before
We come back with a recommendation
Within one working day: EVAR versus open, complex EVAR if needed, the right anaesthetic, an indicative price. If watchful surveillance is still the right step, we say so.
- 03
Before
CT angiogram and planning
A dedicated CT aortogram sizes the neck, iliacs and access vessels. The graft is planned to the millimetre — bespoke for complex cases.
- 04
Admission
Arrival at the hybrid theatre
Arrival, consent and a chat with the vascular surgeon and anaesthetist. GA, regional or local — whichever was chosen.
- 05
Admission
The procedure itself
2 to 4 hours in a hybrid theatre. Bilateral femoral access (percutaneous or cutdown), stent-graft deployed under fluoroscopy, completion angiogram.
- 06
Admission
Overnight admission
24 to 48 hours on a vascular ward. Groins checked, obs monitored, mobilising the next day. Home within two days for most.
- 07
After
Surveillance for life
CT at 30 days, then annual CT or duplex ultrasound. Endoleaks are looked for at every visit. Secondary intervention rate is 5–10% at 5 years.
Typical end-to-end for standard EVAR: 3–4 weeks from enquiry. Complex custom grafts: 6–12 weeks.
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.
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Infrarenal AAA ≥ 5.5 cm (men)
The UK surgical threshold for elective repair in men, per NICE NG156 and NHS AAA screening pathway.
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Infrarenal AAA ≥ 5.0 cm (women)
The lower threshold used for women, reflecting smaller baseline aortic diameter and higher rupture risk per unit size.
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Rapid expansion (> 1 cm per year)
Growth faster than a centimetre a year is a repair indication even below the size threshold.
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Symptomatic aneurysm
Back pain, abdominal pain or tenderness over the aneurysm is a urgent repair indication regardless of size.
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Juxtarenal or thoraco-abdominal
Aneurysms involving the renal or visceral arteries — repaired with fenestrated or branched EVAR (F/BEVAR) in specialist centres.
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Descending thoracic aneurysm
Aneurysms of the thoracic aorta treated with TEVAR — a related endovascular technique with its own risk profile.
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Aorto-iliac disease
Aneurysms extending into the iliac arteries — treated with iliac branch devices to preserve internal iliac flow.
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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.
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Standard infrarenal EVAR
The commonest procedure — a bifurcated stent-graft deployed via both femoral arteries to seal an infrarenal AAA below the renal arteries.
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Fenestrated EVAR (FEVAR)
Custom-made grafts with holes aligned to the renal and visceral arteries — used for juxtarenal aneurysms with a short proximal neck.
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Branched EVAR (BEVAR)
Grafts with side branches to the visceral vessels — used for thoraco-abdominal (Crawford) aneurysms in specialist units.
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TEVAR (thoracic aortic repair)
Endovascular repair of the descending thoracic aorta for aneurysm, dissection or traumatic transection.
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Iliac branch device
A dedicated branch preserves flow to the internal iliac artery when the aneurysm extends into the common iliac.
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Open surgical repair
A laparotomy, aortic cross-clamp and Dacron graft — more durable, higher perioperative morbidity. NICE-preferred for many infrarenal cases.
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Percutaneous vs cutdown access
Femoral access is achieved either with a suture-mediated closure device (ProGlide) or a small surgical cutdown — chosen by anatomy.
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Surveillance only
Aneurysms below threshold are monitored with 3–12 monthly ultrasound or CT until they grow or become symptomatic.
Our vetted UK network
A small panel of vascular surgeons, we picked them.
Consultant vascular surgeons in units with hybrid theatres, complex EVAR volume and on-site vascular ITU. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every vascular surgeon in our network.
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Consultant vascular surgeons on the GMC specialist register
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Hybrid theatre with fixed fluoroscopy, not a mobile C-arm
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On-call vascular cover and ITU on-site for complications
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Open surgical repair offered honestly alongside EVAR
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.
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GA, regional or local all offered
Most EVARs are done under GA, but regional or local with sedation is available for high-risk patients.
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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.
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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.
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Secondary interventions are common
Around 5–10% of patients need a further procedure at 5 years for endoleak, limb occlusion or graft migration.
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Renal impairment risk
Contrast load and suprarenal fixation can worsen kidney function — pre-hydration and renal protection are used routinely.
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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.
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Colonic ischaemia and sexual dysfunction
Rare but recognised — related to covering the IMA and internal iliac arteries. Discussed openly before consent.
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Groin complications
Femoral pseudoaneurysm, lymphocoele, haematoma and wound infection are the commonest early problems.
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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 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.
- 01 Header
Indication and graft chosen
Why the repair was done — size, growth, symptoms — and which platform was used (Endurant, Excluder, Zenith, Ovation, AFX).
- 02 Technique
Access, deployment and completion
Percutaneous vs cutdown femoral access, deployment sequence, adjunctive procedures (cuff, iliac limb extension) and completion angiogram findings.
- 03 Findings
Endoleak status and sac dynamics
Any type I–V endoleak at completion, sac diameter baseline, and plan for the 30-day CT.
- 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
EVAR and open aortic repair are generally covered by UK health insurers when clinically indicated. Pre-authorisation is always required — we confirm cover, exclusions and any excess before booking.
Frequently asked
Everything we get asked about EVAR.
Quick answers on NHS screening, NICE guidance, anatomic suitability, endoleaks and long-term surveillance.
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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.
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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.
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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.
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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. We confirm a firm figure within one working day.
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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.
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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.
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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.
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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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