 Multiple studies have shown significantly decreased length of hospital stay and decreased perioperative morbidity with EVAR [8-11] compared to open repair [12-14]. Despite this, open repair is still performed in patients with unsuitable aneurysm morphology for EVAR and in those with failed EVAR [15]. For patients who present de novo for treatment of AAA without any prior imaging available, the entire aorta (including the thoracic portion) should be assessed to fully characterize the aneurysm and exclude a concomitant thoracic aortic aneurysm. Preoperative imaging for open repair of AAA has one primary focus: to determine the need for surgery based on aneurysm size, extent, and rate of growth. Additional information regarding potential variant anatomy can also be helpful in guiding appropriate treatment and preventing unexpected complications at the time of repair. The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through society representation on expert panels. Participation by representatives from collaborating societies on the expert panel does not necessarily imply individual or society endorsement of the final document. Reprint requests to: publications@acr.org AAA: Interventional Planning & Follow-Up In recent years, new devices have become available to mitigate unfavorable aortic neck anatomy. Several designs feature an uncovered proximal portion that allows for placement of the stent directly at the origin of aortic branches, whereas others possess ready-made vessel origins for placement within the renal and mesenteric arteries [18]. FEVAR is an alternative approach for those with aortic necks of inadequate length. In FEVAR, fenestrations within the graft material allow for perfusion of major visceral arteries while securing an adequate proximal seal [7].
Abdominal Aortic Aneurysm or Dissection Interventional Planning and Follow up.  Multiple studies have shown significantly decreased length of hospital stay and decreased perioperative morbidity with EVAR [8-11] compared to open repair [12-14]. Despite this, open repair is still performed in patients with unsuitable aneurysm morphology for EVAR and in those with failed EVAR [15]. For patients who present de novo for treatment of AAA without any prior imaging available, the entire aorta (including the thoracic portion) should be assessed to fully characterize the aneurysm and exclude a concomitant thoracic aortic aneurysm. Preoperative imaging for open repair of AAA has one primary focus: to determine the need for surgery based on aneurysm size, extent, and rate of growth. Additional information regarding potential variant anatomy can also be helpful in guiding appropriate treatment and preventing unexpected complications at the time of repair. The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through society representation on expert panels. Participation by representatives from collaborating societies on the expert panel does not necessarily imply individual or society endorsement of the final document. Reprint requests to: publications@acr.org AAA: Interventional Planning & Follow-Up In recent years, new devices have become available to mitigate unfavorable aortic neck anatomy. Several designs feature an uncovered proximal portion that allows for placement of the stent directly at the origin of aortic branches, whereas others possess ready-made vessel origins for placement within the renal and mesenteric arteries [18]. FEVAR is an alternative approach for those with aortic necks of inadequate length. In FEVAR, fenestrations within the graft material allow for perfusion of major visceral arteries while securing an adequate proximal seal [7].