Page 39 - Virtual Vascular Vol 6

A final contraindication against EVAR is access issues. This patient has very narrow iliac arter-
A 42-year old lady with Marfan Syndrome and a history of ascending and thoracic aor- ies, at areas less than 5.5mm. Most modern endografts require an access diameter of 6mm
tic replacement. She has a 4.5cm diameter AAA with a very tortuous neck. She was (18Fr)
recommended to have early open repair. Young age, connective tissue disease, and a
very tortuous neck are other reasons for choosing open repair over EVAR. In view of
38 disease progress, repair of the aneuryms before 5cm can be justified. The main risk 39
would be paraplegia.