A variant of the FEVAR technique describes the placement of bridging stents through these fenestrations [23]. Such devices may be especially favorable in women, as these patients are less likely to have aneurysm neck and iliac diameters sufficient for traditional EVAR [16]. FEVAR obviates the need for open femoral exposure and offers the benefit of shorter procedure times, lower complication rates, and shorter hospital stays [5]. FEVAR requires common femoral artery anatomy that is suitable for percutaneous access and free of significant calcification. Candidates for FEVAR should be carefully selected, as the presence and degree of vessel calcification is a major determinant of technical failure [24]. The advantages of EVAR come at a cost of lifelong imaging surveillance. This is due to a higher rate of complications that require reintervention when compared to open repair [11,25]. Complications of EVAR include stent graft migration, kinking, infection, thrombosis, and renal dysfunction. The most important complication to detect is continued aneurysm expansion leading to eventual rupture, which can occur even after successful EVAR [26]. The most common complication of EVAR is endoleak formation, which may contribute to aneurysm sac enlargement and rupture [27]. Endoleaks are classified by their etiology, with Types I and III most commonly leading to rupture [15,28]. Appropriate classification is therefore crucial for subsequent management and should be clarified whenever possible. Although EVAR is safe and has a low mortality rate [29], the possibility of complications and need for reintervention remains high [12-14], thereby requiring life-long monitoring. The ultimate goal of endovascular therapy is to prevent aneurysm rupture. Follow-up imaging is the most useful tool for evaluating post-therapeutic outcomes and monitoring potential complications.
Abdominal Aortic Aneurysm or Dissection Interventional Planning and Follow up. A variant of the FEVAR technique describes the placement of bridging stents through these fenestrations [23]. Such devices may be especially favorable in women, as these patients are less likely to have aneurysm neck and iliac diameters sufficient for traditional EVAR [16]. FEVAR obviates the need for open femoral exposure and offers the benefit of shorter procedure times, lower complication rates, and shorter hospital stays [5]. FEVAR requires common femoral artery anatomy that is suitable for percutaneous access and free of significant calcification. Candidates for FEVAR should be carefully selected, as the presence and degree of vessel calcification is a major determinant of technical failure [24]. The advantages of EVAR come at a cost of lifelong imaging surveillance. This is due to a higher rate of complications that require reintervention when compared to open repair [11,25]. Complications of EVAR include stent graft migration, kinking, infection, thrombosis, and renal dysfunction. The most important complication to detect is continued aneurysm expansion leading to eventual rupture, which can occur even after successful EVAR [26]. The most common complication of EVAR is endoleak formation, which may contribute to aneurysm sac enlargement and rupture [27]. Endoleaks are classified by their etiology, with Types I and III most commonly leading to rupture [15,28]. Appropriate classification is therefore crucial for subsequent management and should be clarified whenever possible. Although EVAR is safe and has a low mortality rate [29], the possibility of complications and need for reintervention remains high [12-14], thereby requiring life-long monitoring. The ultimate goal of endovascular therapy is to prevent aneurysm rupture. Follow-up imaging is the most useful tool for evaluating post-therapeutic outcomes and monitoring potential complications.