ABSTRACT
Endovascular abdominal aortic aneurysm repair (EVAR) has been performed since 1990 (1). A variety of endograft devices have been used at centers around the world (2–6). Although many dramatically successful early results have been achieved and many advantages are claimed, the mid- and long-term durability of these grafts and their effectiveness in preventing rupture remain questionable (7–10). One of the principal reasons for failure after the first year is the occurrence of endoleaks, defined as persistent blood flow outside the graft and within the aneurysm sac (11). Another reason is the presence of endotension, defined as a state of elevated pressure within the aneurysm sac (12).
