Endovascular treatment of morphologically challenging abdominal aortic aneurysms using flexible endograft

Abdominal aortic aneurysms have an incidence rate of 5–9% in men over 60 years of age. Their repair via the endovascular route is now becoming accepted as the treatment of choice. Two of the key factors determining a patient’s eligibility for an endovascular repair include aneurysm neck anatomy and tortuosity of the iliac vessels. Patients who have such challenging morphology are at an increased risk of having complications such as endoleaks, graft migration and limb occlusion. Currently there is no ideal graft available for the treatment of aneurysms that are morphologically challenging. Indeed, the delivery and deployment of traditional grafts that are available for endovascular repair can be extremely challenging in these patients. This article evaluates a flexible modular self-expanding graft (AorfixTM) constructed using a circular Nitinol frame, offering considerable compliance. Its key characteristics, cost and clinical outcome data are presented.