A narrow-waisted abdominal aortic aneurysm complicating endovascular repair

Purpose: To present a case in which a narrow waist in an abdominal aortic a neurysm (AAA) complicated endovascular repair using a modular bifurcated st ent-graft. Methods and Results: A 68-year-old man underwent endovascular repair of a 5 .9-cm asymptomatic AAA with a self-expanding modular bifurcated stent-graft . After insertion and deployment of the stent-graft, the intraoperative com pletion angiogram disclosed unexpected incomplete deployment of the contral ateral iliac limb due to a narrow waist in the aortic aneurysm. Subsequent angioplasty did not increase iliac stent-graft diameter. At follow-up, a ta pered course of the contralateral iliac leg persisted, without hemodynamic significance. Conclusions: A narrow waist in an AAA may be considered an additional impor tant anatomical characteristic in assessing suitability for endovascular re pair.