EVAR may be the preferred treatment method for older, high-risk patients, those with "hostile" abdomens, or other clinical circumstances likely to increase the risk of conventional open repair, if their anatomy is appropriate. Use of EVAR in patients with unsuitable anatomy markedly increases the risk of adverse outcomes, need for conversion to open repair, or AAA rupture. At present, there does not appear to be any justification that EVAR should change the accepted size thresholds for intervention in most patients.