Editing Open AAA repair (section)

== Indications ==

* '''Patients who cannot undergo EVAR'''
** Unfavourable anatomy for EVAR
*** No aortic neck/hostile aortic neck (main indication)
*** Proximal aortic necks that are short (<2cm), angled, trapezoidal, have a high burden of thrombus, or are heavily calcified can compromise seal
*** Iliac artery occlusive disease (especially chronic total occlusion) can mean EVAR Is hard
*** Concomitant CIA or EIA aneurysms (might still be able to do EVAR)
*** Horseshoe kidney
*** Where IMA patency needs to be preserved
** Coexisting disease processes
* Emergency situations and endovascular unavailable
* Younger patients (EVAR durability is questionable)
* Patients with complex aortic neck anatomy (pararenal/suprarenal aneurysms)
* Conversion of EVAR 
** Failure of EVAR due to migration or recalcitrant endoleak that is unable to be resolved by endovascular means
** Tends to be a much more complex operation than de novo AAA repair
** Don't have to completely remove the previous EVAR graft unless it's infected
* Infection of native aorta or previous repair
** Can't be done as open unless in certain situations
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