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©2013 UpToDate ® Print Email Abdominal aortic aneurysm repair (Top) For open surgical repair of abdominal aortic aneurysm, the aorta is clamped and the aneurysm sac opened. A graft is sutured into the aorta proximally and distally. A tube graft (illustrated) or a bifurcated graft is used depending upon the extent of iliac artery disease (aneurysm or stenosis). Once the graft is in place, the aneurysm sac and retroperitoneum are closed over the graft. (Bottom) For endovascular repair, the folded endograft is introduced through the femoral (or iliac) artery and, once it is properly posititioned, the self-expanding endograft is deployed. Iliac artery extensions are positioned and deployed to complete the repair.