Page 46 - Virtual Vascular Vol 6

EVAR Conversion

Endoanchors

This is a 64 year old patient who had a EVAR repair of a large
juxtarenal AAA 2 years ago in a private hospital. Due to the

very short neck a few endoanchors were placed to improve
fixation. The left renal artery is very close to the aneurysm.

Performing EVAR in anatomically unfavorable aneurysms,
even with adjuncts like endoanchors, should be judged very
carefully in view of durability issues and life long surveil-
lance. This is of particular importance when the patient is
young and of low risk, or when the aneurysm is very large.

This aneurysm continued to expand despite the EVAR. No
apparent cause can be found on imaging. Open conversion
is the last resort to prevent continuous expansion and even- The left renal artery (slung) is very close to the aneurysm
46 tual rupture. 47