We recommend using Food and Drug Administration (FDA)-approved branch endograft devices in anatomically suitable patients to maintain perfusion to at least one internal iliac artery. Level of recommendation 1 (Strong), Quality of evidence A (High)
We recommend staging bilateral internal iliac artery occlusion by at least 1 to 2 weeks if required for EVAR. Level of recommendation 1 (Strong), Quality of evidence A (High)
We suggest renal artery or superior mesenteric artery (SMA) angioplasty and stenting for selected patients with symptomatic disease before EVAR or OSR. Level of recommendation 2 (Weak), Quality of evidence C (Low)
We suggest prophylactic treatment of an asymptomatic, high-grade stenosis of the SMA in the presence of a meandering mesenteric artery based off of a large inferior mesenteric artery (IMA), which will be sacrificed during the course of treatment. Level of recommendation 2 (Weak), Quality of evidence C (Low)
We suggest preservation of accessory renal arteries at the time of EVAR or OSR if the artery is 3 mm or larger in diameter or supplies more than one-third of the renal parenchyma. Level of recommendation 2 (Weak), Quality of evidence C (Low)