American Board of Surgery Qualifying Exam (ABS QE) Practice Test

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What is one of the criteria for endovascular aneurysm repair (EVAR)?

  1. Neck length should be less than 10 mm

  2. Neck diameter should be greater than 30 mm

  3. Neck angle should be greater than 60 degrees

  4. Common iliac artery (CIA) diameter should be within 8-18 mm

The correct answer is: Common iliac artery (CIA) diameter should be within 8-18 mm

One of the critical criteria for endovascular aneurysm repair (EVAR) involves the diameter of the common iliac artery (CIA), which should fall within a specific range of 8 to 18 mm. This specification is essential because the device used in EVAR must fit securely and effectively within the vessels to ensure proper sealing and functionality. If the CIA diameter is outside this range, it may lead to complications such as device migration or inadequate wall apposition, which can compromise the repair and increase the risk of an aneurysm rupture. The other choices do not align with the accepted criteria for EVAR. For example, a neck length of less than 10 mm is typically considered a contraindication rather than a criterion for EVAR, as an adequate neck length is crucial for device anchoring. Additionally, a neck diameter greater than 30 mm is not acceptable for EVAR, as this exceeds the limits for many graft designs. Lastly, a neck angle greater than 60 degrees can complicate the procedure and is generally discouraged, as a more acutely angulated neck may lead to challenges in achieving the desired fit and secure placement of the endovascular device.

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