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An abdominal aortic aneurysm (AAA) is a balloon-like bulge or weakened area in the wall of aorta. The larger the aneurysm becomes, the more likely it will rupture which could lead to life-threatening bleeding, and potentially death. Surgical repair of the aneurysm prior to rupture is often life-saving. This can be performed either as an open procedure or endoluminal with a stent graft. The management of abdominal aortic aneurysms (AAA), whether discovered incidentally on imaging studies or by an astute physician on physical exam, continues to have a huge impact on clinical practice and the lives of patients. Through research, the art of medicine, and extensive patient counseling, surveillance versus elective repair continues to be a dynamic and changing science. When indications for elective repair arise, such as worsening symptoms, increased or rapid growth of the aneurysm, or a diameter greater than 5 cm is present, a decision regarding surgical options are brought to the forefront. Open AAA repair was the sole form of surgical treatment until endoluminal repair was introduced into practice in 1991. Much research has been publicized supporting the decreased recovery time and the short term morbidity of endoluminal repair compared to open repair. However, some authors suggest that the benefits of endoluminal repair with respect to mortality rate achieved in the early postoperative period disappear in the long term recovery scheme (Zeebregts et al., 2004). The controversies surrounding endoluminal repair of AAA have involved defining the ideal candidate based on risk factor stratification and overcoming challenging anatomy of the aorta. According to Steinmetz et al, “the ideal candidate for endovascular repair [is] still to be defined” (Steinmetz et al., 2010). However, with new improvements to detect complications intraoperatively, and advances in technology to prevent/treat migration and endoleaks, the quest to determine the ideal candidate may be unnecessary. The presence of an intraoperative endoleak may increase the likelihood of an endoleak being seen during the follow-up period, but not necessarily the likelihood of an additional reintervention or operative procedure (Sampaio et al., 2009). The ultimate goal is to enable the applicability of this elective, minimally invasive approach to prevent the catastrophic event of a ruptured AAA to be widespread. Endoluminal AAA repair obviates the three major physiologic insults associated with open repair laparotomy, aortic cross-clamping, and ischemia reperfusion injury (Halak et al.,

Incidence and Predictors of Clinical Failures Following Catheter-Based Treatment of Abdominal Aortic Aneurysms