The Proximal Neck: The Remaining Barrier to a Complete EVAR World

A sufficient infrarenal aortic neck is one of the key elements for successful outcome after endovascular repair of infrarenal aortic aneurysms (EVAR). The so-called proximal neck must be evaluated thoroughly during pre-operative sizing and planning concerning length, angulation, shape, existence of thrombus and calcification. Dynamic imaging with center lumen line reconstructions are of great help and should be used especially in challenging proximal anatomy. In this manuscript literature has been reviewed concerning the influence of proximal neck morphology on long-term EVAR outcome. Moreover, associations between endograft characteristics and proximal neck sealing will be thoroughly discussed.