What criteria are used to determine whether an aortic aneurysm can be treated by endovascular technique?
• The relationship of the aneurysm to the origins of other vessels: In the abdomen, the relationship of the aneurysm to the renal arteries is of paramount importance because the angiographer would not want to occlude the origin of these arteries with a stent-graft. In the chest, it is preferable not to cover the origin of the left subclavian artery with the stent, but this can be done if needed, with placement of a carotid-subclavian arterial bypass graft.
• The luminal size of the common and external iliac arteries: Because the stent-graft is delivered to the aorta via a femoral artery approach, the angiographer needs a vessel large enough to accommodate the size of the delivery system (currently 6 to 8 mm).
• The length of the aneurysm and whether it extends into the iliac arteries: This determines the size and type of stent-graft used.