Evidence for endovascular aneurysm repair in patients with highly angulated neck anatomy

Patients with highly angulated neck anatomy may account for up to a fifth of all patients treated by endovascular repair. However there is evidence that these patients have worse early and long-term outcomes, including sac expansion. This review explores the evidence supporting the use of endovascular repair in the setting of severe neck angulation, with particular emphasis on new technology with devices that have expanded the anatomical criteria for endovascular aneurysm repair such as the Lombard Aorfix and Medtronic Endurant endografts.