Vascular SurgeryEVAR / TEVAR for Aortic Aneurysm

Aortic and endovascular surgery

EVAR and TEVAR in Germany for Aortic Aneurysm

Understand how German aortic centers evaluate endovascular aneurysm repair (EVAR/TEVAR), when open surgery may still be needed and which imaging records should be prepared for specialist review.

By Treat in Germany Editorial TeamSources reviewed: 2026-08-29Independent clinician review: not yet claimed
Short answer: EVAR and TEVAR use a stent graft to exclude selected aortic aneurysms from the circulation without conventional open replacement of the affected segment. They are not suitable for every aneurysm. The decision depends on aneurysm location, diameter, anatomy, landing zones, branch vessels, connective-tissue disease, previous aortic procedures and the patient's overall operative risk. A specialist aortic team should review CT angiography before any procedure is chosen.

EVAR and TEVAR treat different parts of the aorta

TEVAR refers to thoracic endovascular aortic repair, while EVAR is commonly used for endovascular repair of abdominal aortic disease. DHZC describes endovascular stent-graft treatment for appropriate aneurysms and notes that open surgery remains necessary when anatomy or underlying disease makes an endovascular approach unsuitable.

CT angiography is central to planning

Endovascular repair depends on detailed measurements of the aorta and access vessels. A meaningful second opinion therefore requires the original CT angiography images rather than only a written radiology report.

  • Current CT angiography in DICOM format when requested
  • Aneurysm diameter and exact segment involved
  • Relationship to renal, visceral or arch branch vessels
  • Previous aortic operations or stent-grafts
  • Renal function and contrast-related considerations
  • History of connective-tissue disease or genetic aortopathy

Open surgery may still be the safer or more durable option

A large or anatomically complex aneurysm, inadequate landing zones, infection, some connective-tissue disorders or other technical factors can make open repair preferable. The treatment question is therefore not simply 'Can a stent be inserted?' but which strategy provides an acceptable balance of immediate risk, durability and future reinterventions.

Complex aneurysms may require advanced endovascular techniques

The German Aortic Center Hamburg describes fenestrated and branched stent-graft techniques for selected thoraco-abdominal and post-dissection aneurysms. These cases require highly detailed planning because major branch vessels may need to remain perfused through custom or complex endovascular configurations.

Follow-up imaging is part of the treatment

An endovascular repair is not finished when the stent graft is implanted. Surveillance imaging is needed to evaluate graft position, aneurysm sac behavior, endoleaks and other late complications. International patients should agree on a follow-up schedule and confirm where imaging will be performed after returning home.

Official sources

Sources last checked 2026-08-29. Eligibility, device choice and vascular-center procedures can change; confirm the current plan directly with the treating team.

Medical information notice: This guide is educational and cannot determine whether open surgery, endovascular treatment or conservative management is appropriate for an individual patient. Acute stroke symptoms, suspected aortic rupture or sudden limb ischemia require urgent local medical care.
Verified centers

German centers documenting this service

These are not rankings or paid recommendations. Centers are displayed alphabetically by city and are included because their official websites document the relevant treatment, diagnostic test or specialist program. Availability for an individual patient still requires clinical review.

Aortic and Vascular Center, University Hospital Augsburg

Augsburg · Augsburg publishes open, endovascular and hybrid treatment of abdominal and thoracic aortic aneurysms and dissections, including customized stent-graft solutions for complex anatomy.

German Heart Center at Charité (DHZC) – Aortic Program

Berlin · DHZC publishes dedicated aortic-disease pathways covering conventional surgery and endovascular treatment, including TEVAR and EVAR terminology and follow-up.

German Aortic Center Hamburg (DAZH), UKE

Hamburg · UKE's German Aortic Center documents treatment of complex thoraco-abdominal and post-dissection aneurysms, including fenestrated and branched endovascular stent-graft techniques.

Interdisciplinary Vascular Center, Saarland University Hospital

Homburg · Saarland University Hospital publishes both minimally invasive stent-graft and open surgical treatment of abdominal and pelvic aortic aneurysms, including customized endovascular grafts for complex vascular anatomy.

Interdisciplinary Vascular Center, University Medical Center Leipzig

Leipzig · Leipzig publishes endovascular aortic treatment with EVAR, TEVAR, fenestrated and branched stent-grafts and hybrid procedures for selected aneurysms and dissections.

Vascular Surgery, University Medical Center Mainz

Mainz · Mainz publishes open and endovascular treatment across the entire aorta and visceral arteries within its university heart and vascular surgery service.

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