A recent survey by Datamonitor, US and EU Endovascular AAA Grafts , finds no clear consensus on whether the AAA stent approach is a good one. The issues involved include differences in patient anatomy, the ability of the stent to remain in place, and the durability of the stent materials. The high mortality rate associated with open revisions of stent operations further clouds the picture. The seeming lack of long-term durability of these repairs raises doubts about whether endovascular procedures will become a viable alternative to open surgery. When comparing long-term failure rates, however, the comparison breaks down.
Open surgery presents relatively few problems.
The high cost of the devices is another significant factor. Price is expected to remain constant, and could even rise if a leading product emerges. All products on the market can exclude one or both iliac branches. Both Guidant and Endologix offer unibody configurations without an aortic-iliac limb interface, eliminating the possibility of endoleak. One drawback to this design is the potential for twisting during insertion.