What are the contraindications to EVAR surgery?

So there are some contraindications. So the devices are built to seal in a healthy portion of aorta above the aneurysm and then lower down usually in the iliac arteries. If that seal zone is too wide, then the stents won't seal. If it's too short, then they won't seal. And often if there's a kink in the aorta or what we call an angulation, they won't seal. So in those cases EVAR devices can't be used or shouldn't be used. Sometimes the vessels which would take the aortic stem up into the aorta are too small, and again if they're too small you just can't fit the device in. If someone is very elderly or very frail or has lots of other medical conditions, then it might be that they're going to gain no useful life years from having an EVAR and so the risk of leaving it as it is, is the same as performing the surgery. And so in that case then, I mean that's more of a contraindication to aortic surgery, but I would consider that a contraindication to an EVAR if I thought that the procedure was more likely to harm the patient than benefit them.