Endovascular Aortic Aneurysm Repair in ‘Non-ideal’ Patients – Techniques and Outcomes

Abstract

After almost 20 years of clinical experience, endovascular aortic aneurysm repair (EVAR) has become a well approved and established treatment with a rising prevalence and popularity among vascular specialists. Its initial favourable outcomes have been sufficiently maintained through long-term follow-ups in appropriately selected patients. Improvements to the EVAR technique with the introduction of newer-generation devices as well as enhancements in imaging systems and follow-up modalities have significantly expanded the scope of this treatment. However, there are still many patients with anatomies that preclude them from candidacy or result in sub-optimal outcome, such as an unfavourable neck, tortuosity or difficult access. This article briefly discusses the major known issues affecting EVAR candidacy and outcome and highlights some of the techniques that have been described to overcome these obstacles.