Challenging access in endovascular repair of infrarenal aortic aneurysms.

Endovascular repair has revolutionized the treatment of infrarenal aortic aneurysms. However, its application is still limited in patients with challenging access conditions such as small-caliber vessels, iliac tortuosity, excessive calcification or occlusive disease. The underlying manuscript addresses the crucial role of preoperative access vessel evaluation and summarizes recent developments in endograft manufacturing and surgical techniques allowing for coping with hostile access conditions. Furthermore, alternative access routes and complication management are discussed.