Difficult Neck in Endovascular Aneurysm Repair (EVAR)

Endovascular approach in abdominal aortic aneurysm (AAA) treatment (EVAR) became the treatment of choice for most patients suffering from that disease. However, a successful endovascular therapy of the AAA depends on some key anatomical and morphological fac - tors highly influencing the procedure outcome. Among them, the most important feature is the anatomical situation in the aneurysm neck. The definitions of the terms “hostile neck” and “difficult neck” are explained in order to present unfavorable conditions in the landing zone of most commercially available stent graft models. In this chapter, a description of var - ious criteria of the difficult neck and their basic features and shapes as well was presented. Also, the most popular methods of solving that clinical problem were outlined. At the end, an overall (APPROACH) strategy in the treatment of a hostile neck patient is described.