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Aortic Aneurysms pp 95–119Cite as

Patient Selection Criteria for Endovascular Aortic Aneurysm Repair

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Part of the book series: Contemporary Cardiology ((CONCARD))

Abstract

Endovascular aortic aneurysm repair (EVAR) is being increasingly applied as a less-invasive alternative to open surgical repair of abdominal aortic aneurysms (AAAs). It is an excellent treatment option for AAA when per formed on appropriately selected patients and with adequate preoperative plan ning. Recent trials have reported lower short-term operative mortality rates for EVAR than open surgical repair, but the long-term results of endograft repair are unknown. Preoperative planning and patient selection are essential for good short-term and long-term results and crucial to the successful widespread adoption of EVAR. A thorough understanding of the basic anatomic criteria for EVAR is essential before contemplating the procedure or selecting the ap propriate device. When assessing the arterial anatomy of a patient for potential EVAR, multiple factors need to be considered. These include the quality of ilio-femoral access, the proximal landing zone (infrarenal neck), the anatomy of the aneurysm itself, the anatomy of the distal aorta, and the distal landing zones (most commonly in the common iliac arteries but can be more distal, depending on the patient's pelvic anatomy). Anatomical assessment dictates the particular endograft most suitable, as each endograft design addresses dif ferent anatomical issues and may better accommodate an individual patient's aneurysm. A thorough understanding of these devices is also necessary before a sound clinical decision can be made about which device is the most appropri ate fit for a particular patient's aneurysm. Poor patient or endograft selection will inevitably lead to poor results and significant long-term complications.

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Authors and Affiliations

  1. Department of Radiology, Section of Interventional Radiology, University of Michigan, Ann Arbor, MI

    Venkataramu N. Krishnamurthy

  2. Department of Surgery and Radiology, Sections of Vascular Surgery and Interventional Radiology,, University of Michigan, Ann Arbor, MI

    John E. Rectenwald

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  1. Venkataramu N. Krishnamurthy
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  1. Department of Surgery Sec. Vascular Surgery, University of Michigan Health System, 1500 E. Medical Center Dr., TC2210N, Ann Arbor, MI, 48109-0329, USA

    Gilbert R. Upchurch Jr.  & Enrique Criado  & 

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Krishnamurthy, V.N., Rectenwald, J.E. (2009). Patient Selection Criteria for Endovascular Aortic Aneurysm Repair. In: Upchurch, G.R., Criado, E. (eds) Aortic Aneurysms. Contemporary Cardiology. Humana Press. https://doi.org/10.1007/978-1-60327-204-9_6

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