Elective and emergent repair of abdominal aortic aneurysm: selection of open or endovascular strategy

Abstract

Abdominal aortic aneurysm (AAA) is a disease that contemporary medicine cannot treat without intervention. Vascular surgeons are faced with two challenging decisions: how to treat AAA and when to treat asymptomatic AAA? Open repair (OR) as conventional procedure has been performed for 70 years, and the results have been substantially improved in recent decades. Endovascular aneurysm repair (EVAR) is a less invasive method invented 30 years ago and has been improving for decades in terms of its feasibility and durability. If not treated timely and properly, AAA may develop rupture (rAAA). Such a severe complication can be devastating to multiple organs and systems in the human body, frequently causing death. Due to its urgent nature, rAAA brings additional challenges that determine strategy and selection of treatment modality. The possibility of offering both options, OR and EVAR, and a careful choice of treatment strategy is probably the key point in achieving optimal results. In this article, our view on both, open and endovascular repair of ruptured and elective AAA, will be presented. © 2022 Elsevier Inc. All rights reserved.