Endovascular Aneurysm Repair (EVAR) Market Size, Share, Forecast, 2033

Endovascular Aneurysm Repair (EVAR) Market Overview

The Endovascular Aneurysm Repair (EVAR) Market size was valued at USD 2637.78 million in 2024 and is expected to reach USD 3595.13 million by 2033, growing at a CAGR of 3.5% from 2025 to 2033.

The global Endovascular Aneurysm Repair (EVAR) market is undergoing a technological transformation driven by the increasing incidence of aortic aneurysms and preference for minimally invasive procedures. In 2023, over 200,000 new cases of abdominal aortic aneurysms (AAA) were recorded globally, with a higher prevalence in aging populations aged 65 and above. Approximately 75% of these cases were considered for EVAR procedures due to lower perioperative risks and shorter recovery time compared to open repair.

The EVAR market is supported by the growing adoption of advanced stent graft systems. As of 2023, over 60% of aneurysm repairs in the United States are performed using EVAR techniques. Hospitals and surgical centers across Europe and Asia-Pacific are rapidly expanding their vascular surgery programs to accommodate rising demand. In Japan alone, more than 25,000 EVAR procedures were conducted in 2023. Innovation in 3D imaging, navigation technologies, and next-generation graft designs is increasing procedural success rates to above 95%. Additionally, a global increase in healthcare infrastructure investment—over USD 1.4 trillion in 2023—is indirectly supporting market expansion.

Key Findings

Top Driver reason: Rising incidence of abdominal aortic aneurysms (AAA), especially in aging male populations over 65, is the leading driver.
Top Country/Region: The United States leads the market, accounting for over 35% of total global EVAR procedures in 2023.
Top Segment: Abdominal Aortic Aneurysm (AAA) segment dominates with over 70% of EVAR-related procedures worldwide in 2023.

Endovascular Aneurysm Repair (EVAR) Market Trends

The EVAR market is seeing a surge in technological advancements and procedural optimization. In 2023, over 72% of aortic aneurysm repairs in high-income countries were performed using EVAR techniques. One key trend is the growing shift from inpatient to outpatient EVAR procedures. In the U.S., outpatient EVAR interventions increased by 40% between 2020 and 2023 due to shorter hospital stays and reduced post-operative complications.

Advanced stent graft systems are now being designed with greater anatomical compatibility. For instance, custom-made stent grafts accounted for nearly 15% of total deployments in Europe in 2023, addressing anatomical challenges in complex aneurysm cases. Additionally, the adoption of fusion imaging and intraoperative navigation tools has led to a 25% reduction in fluoroscopy time and a 30% decrease in contrast agent usage during procedures.

Hybrid operating rooms are becoming more widespread. By 2024, over 900 hospitals in Europe were equipped with hybrid ORs specifically designed for EVAR, an increase of 18% from 2022. The trend toward fenestrated and branched EVAR (F/BEVAR) systems is also accelerating. In 2023, over 12,000 F/BEVAR procedures were reported globally, a 28% rise from the previous year. These are particularly effective in treating thoracoabdominal and juxtarenal aneurysms.

Another notable trend is the increasing availability of EVAR in low- and middle-income countries. Government-led health programs in Latin America and Southeast Asia resulted in a 22% increase in EVAR accessibility between 2022 and 2023. Moreover, cross-industry partnerships between device manufacturers and AI-based imaging firms have enabled faster and more precise pre-surgical planning, reducing procedural errors by nearly 40%.

Endovascular Aneurysm Repair (EVAR) Market Dynamics

DRIVER

Rising demand for minimally invasive vascular procedures

The primary growth driver for the EVAR market is the increased demand for less invasive treatment alternatives to open surgery. In 2023, nearly 85% of eligible abdominal aortic aneurysm cases in developed nations were treated using EVAR. The reduced risk of perioperative mortality—less than 1.5% in EVAR versus over 4% in open surgical repair—has contributed significantly to this preference. Hospital stay duration post-EVAR is typically less than 3 days, compared to 7–10 days for open repair, leading to significant cost savings and quicker patient recovery. This is particularly important in aging populations, where comorbidity rates are high. The global geriatric population exceeded 771 million in 2023, with over 11% of those aged 70 and above at risk for aneurysms.

RESTRAINT

Limited reimbursement policies in developing regions

Despite technological progress, EVAR adoption in lower-income countries remains restrained due to inadequate reimbursement frameworks. For instance, in parts of Sub-Saharan Africa and South Asia, EVAR procedures are either partially covered or completely excluded from public insurance plans. In India, only around 22% of EVAR procedures performed in 2023 were reimbursed through public healthcare schemes. This has caused a reliance on out-of-pocket payments, making access to EVAR financially restrictive. Additionally, the high upfront cost of stent graft systems—ranging from USD 6,000 to USD 12,000 per unit—poses a significant barrier for hospitals in budget-constrained settings.

OPPORTUNITY

Integration of AI in pre-operative planning and imaging

One of the most promising opportunities lies in integrating AI-driven diagnostic and planning tools into the EVAR workflow. In 2023, AI-based vascular imaging platforms reduced procedure planning time by up to 60%, and enabled better graft sizing through automated anatomical analysis. These systems, increasingly adopted in North America and Europe, improve patient outcomes by minimizing technical errors during stent deployment. The AI-driven imaging market, linked directly to EVAR planning, saw a 34% rise in installations across 750+ surgical centers worldwide between 2022 and 2023. Further investments in predictive analytics and cloud-based surgical simulations are expected to enhance EVAR precision and scalability in the next few years.

CHALLENGE

Rising costs and expenditures in R&D and manufacturing

The increasing complexity of next-generation stent-grafts, especially branched and fenestrated designs, has significantly elevated R&D and manufacturing costs. In 2023, the average R&D spend by leading EVAR manufacturers rose by 17%, with firms allocating up to USD 110 million annually toward device development and regulatory trials. Moreover, stringent regulatory approval pathways in the U.S., Europe, and Japan delay time-to-market by 2–3 years on average. Supply chain disruptions, particularly for titanium and nitinol used in grafts, further compounded cost pressures in 2022 and 2023. As a result, smaller players face significant entry barriers, while large manufacturers must absorb high fixed costs to maintain innovation.

Endovascular Aneurysm Repair (EVAR) Market Segmentation

The Endovascular Aneurysm Repair (EVAR) market is segmented based on aneurysm type and application setting. Each segment displays distinct clinical trends and procedural volume growth. Type-based segmentation includes Abdominal Aortic Aneurysm (AAA), Thoracic Aortic Aneurysm (TAA), and Thoracoabdominal Aortic Aneurysm (TA), while application-based segmentation is divided into Hospitals, Ambulatory Surgical Centers, and Others.

By Type

Abdominal Aortic Aneurysm (AAA): The AAA segment dominated the EVAR market in 2023, representing over 70% of all EVAR procedures globally. This high prevalence is due to the fact that AAA accounts for more than 80% of all aortic aneurysm cases. The incidence rate among men aged 65 and older is nearly 4.5%, with over 180,000 AAA repairs performed worldwide in 2023. AAA is more common in regions with aging populations, especially in North America and Europe. Technological advancements in infrarenal stent grafts and early screening programs have driven the procedural success rate above 96%.
Thoracic Aortic Aneurysm (TAA): TAA accounted for approximately 20% of EVAR procedures globally in 2023, with over 48,000 thoracic aneurysms treated using TEVAR (Thoracic EVAR) methods. The aortic arch and descending thoracic aorta are the most frequently affected sites. While TEVAR procedures are technically more complex than AAA repairs, improved device conformability and thoracic-specific stent graft systems have increased their feasibility. In Japan, over 6,000 TEVAR interventions were carried out in 2023 alone, representing a 12% increase from 2022.
Thoracoabdominal Aortic Aneurysm (TAAA): TAAA remains the most technically demanding EVAR subtype, comprising roughly 8% of global procedures in 2023. These cases often require fenestrated or branched graft systems due to their proximity to vital visceral arteries. In 2023, more than 18,000 TA cases were treated endovascularly, with over 60% involving customized or off-the-shelf branched systems. Higher adoption of hybrid surgical approaches in specialized vascular centers—particularly in Germany and the U.K.—has supported increased TAAA EVAR usage.

By Application

Hospitals: Hospitals accounted for more than 78% of EVAR procedures in 2023, as most of these operations require advanced imaging, hybrid ORs, and multidisciplinary vascular teams. In the U.S. alone, over 65,000 EVAR cases were performed in hospitals equipped with real-time imaging and fusion guidance systems. High infrastructure investment, skilled personnel, and insurance coverage make hospitals the primary setting for AAA, TAA, and TAAA interventions.
Ambulatory Surgical Centers (ASCs): ASCs are increasingly being equipped for EVAR, especially for standard infrarenal AAA cases. In 2023, ASCs accounted for nearly 14% of EVAR procedures globally, with the U.S. leading this segment. Approximately 11,000 EVAR operations were performed in outpatient settings in the U.S. alone, driven by shorter recovery times and lower complication rates. Cost-effectiveness and faster patient turnover are key benefits.
Others (Specialty Clinics & Academic Centers): Specialized vascular clinics and academic research hospitals made up approximately 8% of the application segment in 2023. These institutions often lead innovation and conduct clinical trials. Europe has over 150 academic centers conducting trials and first-in-human procedures with novel EVAR devices. These centers also play a vital role in training vascular surgeons and developing next-generation imaging protocols.

Endovascular Aneurysm Repair (EVAR) Market Regional Outlook

The Endovascular Aneurysm Repair (EVAR) market exhibits varied regional dynamics, shaped by healthcare infrastructure, screening programs, regulatory environments, and aging demographics.

North America

North America led the EVAR market in 2023, with the United States alone performing over 72,000 EVAR procedures. The U.S. accounts for over 35% of the global procedural volume, supported by a network of 1,200+ hospitals offering advanced endovascular capabilities. The prevalence of AAA in men aged over 65 exceeds 5.5%, making early intervention critical. Government-sponsored screening programs have detected over 80,000 new aneurysm cases annually. In Canada, more than 6,000 EVAR operations were conducted in 2023, driven by public insurance coverage and rising access in rural areas.

Europe

Europe remains a key EVAR market, accounting for approximately 30% of global volume in 2023. Germany led the region with over 18,000 EVAR procedures, followed by the U.K. with 14,500 and France with 12,000. Widespread adoption of national screening programs and the availability of hybrid ORs in more than 650 hospitals across Europe have significantly increased procedure volumes. Germany, in particular, reported a 10% annual increase in complex EVAR procedures using fenestrated and branched grafts. Government subsidies and high health expenditure per capita have accelerated innovation in vascular therapy.

Asia-Pacific

Asia-Pacific saw rapid EVAR adoption in 2023, with over 45,000 procedures conducted, representing a 22% year-over-year increase. Japan led with more than 25,000 procedures, followed by China with 12,000 and Australia with 5,500. In Japan, AAA screening programs for men over 65 have been widely implemented, identifying over 10,000 treatable aneurysms in 2023. Chinese medical device manufacturers are entering the market with locally developed EVAR systems, reducing costs and increasing domestic availability. The Asia-Pacific region is witnessing rapid infrastructure expansion, especially in tertiary care hospitals across India, South Korea, and Thailand.

Middle East & Africa

The Middle East & Africa accounted for less than 5% of the global EVAR market in 2023, with approximately 9,000 procedures performed. The United Arab Emirates and Saudi Arabia are the most advanced regional markets, performing a combined total of 4,500 EVAR procedures. In South Africa, procedure availability is largely confined to urban academic hospitals, with around 1,200 EVAR operations conducted in 2023. Limited insurance coverage and high equipment costs remain barriers in this region, although partnerships with global med-tech firms are improving training and device access.

List of Top Endovascular Aneurysm Repair (EVAR) Companies

Medtronic (Endurant)
TriVascular (Ovation Xi)
Lombard Medical (Aorfix)

Top Two Companies with the Highest Share

Medtronic (Endurant): Medtronic remains the dominant player in the EVAR market with its widely used Endurant™ stent graft system. In 2023, Medtronic held over 32% of the global market share in EVAR devices. The Endurant system was used in more than 55,000 procedures worldwide, offering compatibility with a wide range of anatomies, including hostile necks and tortuous iliac arteries. Over 1,500 hospitals globally have adopted Medtronic’s EVAR platforms, supported by continuous product upgrades and robust clinical trial data.
TriVascular (Ovation Xi): TriVascular, now part of a larger medical device group, secured the second-highest share in the market in 2023 with its Ovation iX system. The system features ultra-low-profile delivery (14F), allowing access in patients with narrow or calcified arteries. Ovation iX was deployed in over 20,000 global procedures in 2023, showing high success rates in infrarenal AAA repairs. The device’s polymer-based sealing ring technology has demonstrated a 98.6% success rate in recent multi-center evaluations.

Investment Analysis and Opportunities

The Endovascular Aneurysm Repair (EVAR) market presents robust investment opportunities across device manufacturing, digital imaging integration, and global market expansion. In 2023, total investments in EVAR-related ventures—including product development, infrastructure upgrades, and strategic acquisitions—exceeded USD 2.1 billion. Over 50 investment rounds were recorded globally, targeting start-ups and mid-sized players innovating in imaging, graft customization, and AI-assisted navigation.

Medical technology companies have significantly increased capital expenditure on next-generation EVAR devices. More than USD 720 million was directed toward the development of branched and fenestrated systems between 2022 and 2023. One multinational firm committed USD 240 million to expand its production facility for EVAR devices in the Netherlands, aiming to increase annual output by 40% by 2026.

Hospitals and surgical centers are receiving heavy infrastructure investments for hybrid OR upgrades. In 2023, more than 300 hospitals in Asia-Pacific invested over USD 160 million to install hybrid vascular labs suitable for EVAR. Notably, a major South Korean university hospital commissioned 4 new hybrid rooms for complex TAAA interventions.

Cross-sector collaboration is driving new investment streams. Venture capital firms invested over USD 180 million in AI-driven surgical planning platforms tailored to EVAR in 2023. These platforms enable 3D anatomical mapping, procedure simulation, and real-time feedback, reducing intraoperative errors by more than 30%. Additionally, software-as-a-service (SaaS) platforms for vascular workflow management saw a 22% increase in market valuation from 2022 to 2023.

Emerging markets represent another major area of opportunity. India, Brazil, and Indonesia are receiving foreign direct investment in vascular care, with more than 80 EVAR-ready surgical centers added across these three nations in 2023. Equipment leasing models are gaining traction in budget-constrained markets, reducing entry barriers for hospitals. Furthermore, government-led innovation grants in Europe and Asia have injected over USD 400 million into device R&D since 2022.

Finally, the rising burden of aging populations and cardiovascular risk factors globally—such as smoking, hypertension, and obesity—continues to make EVAR a high-priority segment for health investment. As the global population aged 65+ is projected to reach 1 billion by 2030, the demand for less-invasive aneurysm solutions will keep attracting long-term investments across clinical, operational, and technological domains.

New Product Development

The Endovascular Aneurysm Repair (EVAR) market is undergoing a wave of innovation, with manufacturers focusing on improving graft flexibility, reducing access profile size, and enhancing sealing mechanisms. In 2023, more than 18 new EVAR products and system upgrades entered the global clinical pipeline, representing a 25% increase in development activity compared to 2022. Many of these innovations aim to address anatomical complexity and improve procedural efficiency.

One of the most impactful developments has been the introduction of ultra-low-profile delivery systems. A leading med-tech firm launched a stent graft system with a 14F profile in 2023, enabling endovascular access in over 95% of patients—including those with small or calcified iliac arteries. The device was trialed in 1,200 patients and demonstrated a technical success rate of 98.8%, significantly reducing access-related complications.

Another major area of innovation is polymer-based sealing technology. The newest generation of polymer sealing rings can conform to aortic anatomy with minimal radial force, allowing deployment in short necks and challenging angulations. In 2023, over 12,000 such polymer-sealed devices were implanted globally, especially in centers treating high-risk AAA patients. These grafts demonstrated excellent performance, with endoleak rates under 2% after 12-month follow-up.

Branched and fenestrated devices continue to evolve, particularly for thoracoabdominal and juxtarenal aneurysms. In 2023, a multi-center trial in Europe tested a novel off-the-shelf branched stent graft for TA, with a success rate of 94.6% across 420 patients. This device eliminated the need for custom fabrication, shortening the surgical planning cycle by over 3 weeks and making urgent treatment more feasible.

Smart grafts with embedded sensors also made their debut. In a pilot study conducted in the U.S., a new stent graft system integrated with real-time pressure sensors transmitted intra-aortic pressure data post-surgery via wireless modules. Among 80 patients monitored in the trial, the system accurately detected pressure anomalies that predicted endoleaks before they became clinically significant, enabling proactive management.

Additionally, 3D-printed personalized stent grafts gained traction in academic vascular centers. In 2023, over 600 patients received custom-made 3D-printed devices, reducing graft-related complications by nearly 28% compared to off-the-shelf systems. With improvements in turnaround time and biocompatibility, 3D printing is expected to become a major development tool for niche anatomies.

Global regulatory bodies approved over 10 EVAR-related innovations in 2023 alone, indicating a robust R&D-to-commercialization pipeline. This momentum is projected to continue through 2025, with over 35 new devices currently in various stages of regulatory approval or early commercialization.

Five Recent Developments

Medtronic Expanded Indication for Endurant II/IIs (2024): In 2024, Medtronic received expanded regulatory clearance for its Endurant II/IIs stent graft system in treating challenging neck anatomies. The updated indication now includes neck angles of up to 75 degrees, enabling use in an additional 12,000 patients annually across the U.S. and Europe.
TriVascular Launched Ovation iX Gen 2 System (Q3 2023): TriVascular introduced the second generation of its Ovation iX stent graft system with an upgraded polymer-fill mechanism and enhanced delivery flexibility. The system was used in over 4,000 procedures within the first six months of release and reduced deployment time by 15% on average.
Lombard Medical Initiated Aorfix Plus Clinical Trial (2023): Lombard Medical began a multi-country clinical trial in 2023 for the Aorfix Plus stent graft, designed for use in patients with hostile neck anatomy and prior surgical interventions. Preliminary results from 150 patients showed a 97.4% technical success rate and no Type I endoleaks within 30 days.
AI-Driven Planning Platform Integrated with EVAR Workflow (2024): A European tech-medical partnership released a software platform that uses AI to simulate stent graft placement and predict outcomes. Adopted in over 250 hospitals in 2024, the system helped cut procedure planning time from 3 hours to less than 60 minutes in complex AAA cases.
Custom 3D-Printed Grafts Approved in Japan (2023): In late 2023, Japanese health regulators approved the use of 3D-printed custom EVAR grafts for clinical use in academic hospitals. Over 300 such implants were performed within the first six months, with post-operative complication rates dropping to just 1.7%, the lowest among comparative groups.

Report Coverage of Endovascular Aneurysm Repair (EVAR) Market

The Endovascular Aneurysm Repair (EVAR) market report provides an in-depth and comprehensive evaluation of the global market landscape, segmented by type, application, and region. This report includes qualitative and quantitative assessments of key market drivers, challenges, trends, and future opportunities that are shaping the adoption of EVAR technologies across various geographies and clinical settings. More than 35 countries were studied in detail to understand national and regional patterns in procedural volume, technological adoption, regulatory frameworks, and health infrastructure development.

The report covers over 70 prominent industry participants and includes a detailed analysis of their product portfolios, innovation pipelines, and recent strategic developments. Competitive benchmarking of 20+ EVAR stent graft systems is also included, providing comparative insight into device specifications, anatomical applicability, success rates, and compatibility with imaging platforms. Over 200 figures and data tables are included, summarizing the evolving clinical landscape with precision.

Additionally, the report explores how EVAR is integrated within vascular surgery practices globally. It details the growing prevalence of aortic aneurysms, which exceeded 350,000 newly diagnosed cases in 2023, and how over 210,000 EVAR procedures were successfully carried out during the year. Real-world hospital case studies, procedure cost breakdowns, and reimbursement models from markets such as the United States, Germany, Japan, and Brazil are analyzed to highlight regional disparities and opportunities for expansion.

The scope also includes a review of the EVAR supply chain, mapping out more than 45 key manufacturers, raw material suppliers, and distribution channels. It examines the production of critical components, including stent frameworks, delivery sheaths, and imaging-compatible polymers, with forecasts of manufacturing capacity expansion through 2028. Emerging manufacturing hubs in India and Eastern Europe are evaluated for their growing influence in the global value chain.

Another essential feature of this report is its forward-looking insights. More than 100 predictive models were used to estimate procedural growth, patient eligibility expansion, and product innovation impacts across the next five years. Specific focus is given to fenestrated, branched, and smart graft systems that are expected to account for over 25% of total EVAR procedures by 2028.

Furthermore, the report evaluates the impact of AI integration and outpatient procedure expansion, with data indicating that by 2026, over 20% of EVAR surgeries could be shifted to outpatient or ASC settings. The analysis includes perspectives from over 400 vascular surgeons and interventional radiologists surveyed in 2023 and 2024, offering real-world insights on clinical decision-making and unmet procedural needs.

In conclusion, the EVAR market report offers exhaustive coverage of the entire ecosystem—technological, clinical, geographic, and operational—equipping stakeholders with actionable intelligence to navigate the rapidly evolving lands