Abstract
After the Zenith stentgraft was approved in Japan in 2006, a large number of EVARs (Endovascular aneurysm repairs) have been performed across Japan. Many physicians have obtained wide experience and advanced their skills, and so outside IFU (Instruction for use) cases are now also treated by EVAR. Useful techniques for overcoming challenging anatomy for EVAR are introduced in this article. These techniques include PTA (percutaneous transluminal angioplasty) and internal endoconduit for narrow iliac access, brachio-femoral wire for tortuous iliac access, and slow deployment for angulated proximal neck. This article describes some AAA (abdominal aortic aneurysm) cases with complicated anatomy, which were successfully treated by EVAR with these ancillary endovascular techniques. In addition, bailout techniques for device related complications are briefly discussed.
