Conservative treatment, stent grafting or open repair of abdominal aortic aneurysms

The incidence of abdominal aortic aneurysm (AAA) is increasing in most parts of the world and the natural history is death from rupture unless the patient dies from another cause prior to rupture. The treatment of the aneurysm involves insertion of a vascular prosthesis sutured proximally to the non-dilated segment of the aorta and distally either to the neck below the aneurysm or on a convenient place in the iliac or femoral arteries. The endovascular technique has brought the possibility of inserting and securing this prosthesis in the aorta by use of stents which replace surgical suture and act as friction seals. This may in the future alter the indications for intervening against the AAA. In this short review the possibilities offered for treatment and how and when they should be used, are discussed.