New EVAR devices: pros and cons

The first randomized controlled trials comparing the two procedures (EVAR versus open repair) for the treatment of abdominal aortic aneurysms showed considerably better short-term outcomes and on the other side higher rates of device-associated reinterventions and remarkable financial burden in the endovascular arm. In the meantime, specialists experience and expertise have been improved significantly. To solve the reported drawbacks and to prevent endografts-associated complications, safer fixation features, lower profile, more flexible design and new revolutionary release and deployment mechanisms of stent-grafts have been also developed and established over the last years. In this review, we present the new EVAR devices and attempt to provide an overview of their premature performance based on the literature and the clinical practice in our institution.