Persistent EVAR Challenges
•Inadequate neck •Access vessels•Nearly 35% of men and 60% of women remain ineligible for EVAR •Treatment optionsOpen repair, fenestrated / branched endografts, off-label EVAR, or watchful waitingCharacteristics of Hostile Access Anatomy: Narrow (<6mm); Occluded; Tortuous; Calcified; Aneurysmal
Low Profile Graft: Incraft  14F OD Addresses 83% of AAA populationBenefits of low profile: Higher success rates and fewer complications; shorter LOS; Patient satisfaction; increase the application for EVAR especially in small iliac arteries

Incraft  WA  AAA Registry
Prospective Independent: Feb 2018 -  May 2020Ethics approval obtainedTwo Surgeon, Three institutionsPreop, Intraop, Post op Data CollectedFollow-up period:  3-6m, 12m then annuallyExcel Database and Analysis
Study end points Technical and Procedural Endpoint • successful delivery, deployment and removal of delivery device • no type I/III endoleak, unintentional coverage of visceral aortic branches of internal iliac arteries,    Clinical Endpoints • 30 day major vascular complications including aortic dissection/rupture, access site related injuries,    distal embolization resulting in amputation of irreversible end organ damage • Major adverse evets: death, MI, CVA, renal failure at 30 days and 1 year • All-cause death at 30 days and 1 year • Aneurysm related death at 30 days and 1 year • Reintervention at 1 year • Endoleak at 30 days and 1 year

22 patients have been recruited so far over 2 centres in Western Australia
- 86.5% Males - 13.5% Females Mean age of patients 76.9 years 30 day outcomes, early follow up outcomes and anatomical & technical details are as described the following tables

Limitations: Series unselected, small, short follow-upBenefits: Easy to Use; Flexible; Reduced delivery problems; High Technical Success; Low profile; Increased EVAR pool; Perfusion lower limbEarly outcomes: Satisfactory; Cost Reduction; ICU LOS, 1 Proglide; Same Day DischargeSimilar to other series: Innovation(Italian), US reportedCurrently our graft of choice for conventional EVAR Registry Continuing