Evaluating the decision to use Fenestrated EVAR for the elective treatment of a complex AAA

An aneurysm is defined as a focal dilatation of all three walls of an artery wall. This can occur at any point in the arterial tree but most commonly presents as an abdominal aortic aneurysm (AAA), with a diameter of 50% greater than its normal size. The prevalence of AAAs is estimated to be between 1.2-7.6% in over 50 year olds in the UK, and it is sevenfold higher for men compared with women1. There is approximately a 1% mortality from ruptured AAAs, and as such current NHS guidelines recommend that all men over 65 are screened annually, a precedent supported by the Multicentre Aneurysm Screening Study (MASS)2. AAAs reaching 5.5cm in diameter require elective surgical repair, which can take the form of endovascular aneurysm repair (EVAR) or open surgical repair.