WHAT ARE THE CHARACTERISTICS OF THE IDEAL ENDOVASCULAR GRAFT FOR ABDOMINAL AORTIC-ANEURYSM EXCLUSION

Purpose: To review the anatomic factors crucial to successful endolumi nal abdominal aortic aneurysm (AAA) repair and propose an ideal endogr aft design for AAA exclusion. Methods and Results: The anatomic featur es of critical importance to endovascular AAA exclusion comprise remot e arterial access, proximal and distal fixation sites, AAA morphology, and arterial wall pathology. When designing an aortic endograft, the major components to consider are stent selection, graft material, and the delivery system. The ideal endograft design must be sufficiently v ersatile to treat a broad range of patients. To meet this requirement, the endograft should display a high degree of dimensional adaptabilit y. A modular bifurcated endograft design permits intraoperative custom ization to tailor the device to each patient's anatomy and pathology. Conclusions: The modular stent-graft concept addresses many of the imp ortant factors in the evolution toward an ideal aortic endograft. Exte nsive testing will be needed to determine if the bifurcated stent-graf t described here is the optimal design for effective AAA exclusion.