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Changes in abdominal aortic aneurysm epidemiology.

Fredrik Lilja1, Anders Wanhainen1, Kevin Mani2

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|June 22, 2017
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Summary
This summary is machine-generated.

Over the last 30 years, abdominal aortic aneurysm (AAA) treatment has shifted towards endovascular aortic repair (EVAR) and screening, reducing ruptured AAA cases and improving survival rates for all AAA repairs.

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Area of Science:

  • Vascular surgery
  • Epidemiology
  • Public health

Background:

  • Abdominal aortic aneurysm (AAA) epidemiology and treatment have undergone significant transformations over the past three decades.
  • Key changes include the introduction of endovascular aortic repair (EVAR), widespread population screening programs, and a notable decrease in AAA prevalence.
  • These shifts have impacted the incidence of both intact and ruptured AAA repairs, as well as overall patient outcomes.

Purpose of the Study:

  • To provide an overview of the evolving trends in AAA epidemiology, management strategies, and patient outcomes.
  • To highlight the impact of EVAR and population screening on AAA treatment and survival.
  • To discuss the increasing proportion of elderly patients undergoing AAA repair.

Main Methods:

  • This review synthesizes data from international vascular registries and epidemiological studies.
  • It analyzes trends in AAA management, focusing on the adoption of EVAR versus open repair.
  • The review examines changes in the incidence of intact versus ruptured AAA repairs and their associated survival rates.

Main Results:

  • The introduction of EVAR has led to an increased incidence of intact AAA repair and a decreased incidence of ruptured AAA repair.
  • Overall survival rates for both intact and ruptured AAA repair have improved, largely attributed to the widespread adoption of EVAR.
  • Elective and rupture repair rates have increased in the elderly population, with octogenarians comprising a significant percentage of treated patients in some regions.

Conclusions:

  • Modern AAA management is increasingly dominated by elective EVAR, with a continuing decline in ruptured AAA repair incidence.
  • Significant improvements in both short-term and long-term survival following AAA repair have been observed.
  • Despite advancements, international variations in AAA management and outcomes persist, warranting further investigation and standardization.