Pararenal aneurysms: currently available fenestrated endografts.

Endovascular aneurysm repair (EVAR) is a valid treatment option for abdominal aortic aneurysm (AAA). The outcome of infrarenal EVAR is dependent on choosing patients with appropriate anatomy to allow for good proximal and distal seal. In the absence of an infrarenal neck of adequate length and quality, fenestrated stent-graft repair has emerged as an alternative treatment option. For the past decade there has only been one type of fenestrated endograft on the market. This has shown good short- and midterm outcome in many centers. This graft is custom designed for each individual patient. Over the past few years further development has led to the introduction of new, off-the-shelf stent-graft for fenestrated repair and some new companies have entered the marketplace. Most of these new devices are still in their infancy and currently undergoing clinical trials but add promise to the development of pararenal aortic repair.