Recommended management of the internal iliac artery

As an adjunct to EVAR, bilateral hypogastric artery occlusion may be acceptable in certain anatomic situations for patients at highrisk for OSR (Grade 1, Level B).

Role of EVAR in patients requiring urgent or emergent repair

Emergent EVAR should be considered for treatment of a ruptured AAA, if anatomically feasible (Grade 1, Level B).

Role of EVAR in high-risk and unfit patients for open repair

EVAR may be considered for high-risk patients unfit for surgical repair (Grade 2, Level C).

Perioperative outcomes of elective EVAR

EVAR should be performed at centers with documented in-hospital mortality for elective EVAR of less than 3% and a perioperative conversion rate to OSR of less than 2% (Grade 1, Level A).