Who is a candidate for endovascular repair?
Because of the dangers associated with treating the body’s largest blood vessel, intervention generally is not recommended until an aortic aneurysm grows to 5 or 6 centimeters in diameter and the risk of rupture exceeds surgical risks. About 50 percent of patients with aortic aneurysm meet the anatomical criteria to be viable candidates for EVAR. Arteries need to be of a certain size to accommodate the catheter and graft, and there must be sufficient viable vessel above and below the site of the aneurysm for the graft to attach without leakage. New and innovative procedures that combine endograft with a less invasive open surgery also are being developed. Endovascular surgeons are working with colleagues in vascular surgery to develop techniques of combined procedures that can render the aorta amenable to endovascular repair. If a thoracic aneurysm comes close to the origin of the iliac artery, for example, a smaller open procedure can be done through the abdomen to move the artery, an
