Geometrical factors influencing the hemodynamic behavior of the AAA stent grafts: essentials for the clinician.

Endovascular aneurysm repair (EVAR) is considered to be the treatment of choice for abdominal aortic aneurysms (AAA). Despite the initial technical success, EVAR is amenable to early and late complications, among which the migration of the endograft (EG) with subsequent proximal endoleak (Type Ia) leads to repressurization of the AAA sac, exposure to excessive wall stress, and, hence, to potential rupture. This article discusses the influence that certain geometrical factors, such as neck angulation, iliac bifurcation, EG curvature, neck-to-iliac diameter, and length ratios, as well as iliac limbs configuration can exert on the hemodynamic behavior of the EGs. The information provided could help both clinicians and EG manufacturers towards further development and improvement of EG designs and better operational planning.