Evolving Approaches to Abdominal Aortic Aneurysms: A Short Review
Article Sidebar
Main Article Content
Abstract
Abstract
Abdominal Aortic Aneurysm (AAA) remains a significant cause of morbidity and mortality, particularly in older adults. Over the past two decades, advances in imaging, risk stratification, and treatment modalities have transformed the management of AAA. This short review highlights the current understanding of AAA pathophysiology, summarizes screening and surveillance strategies, and discusses the evolution of surgical approaches, particularly the shift from open surgical repair to Endovascular Aneurysm Repair (EVAR). Ongoing innovations and unresolved challenges are also briefly addressed.
Downloads
Article Details
Copyright (c) 2025 Suraj P, et al.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Norman PE, Powell JT. Abdominal aortic aneurysm: the prognosis about size. Eur J Vasc Endovasc Surg. 2010;39(2):197–201. Available from: https://doi.org/10.1016/j.ejvs.2009.11.003
Moll FL, Powell JT, Fraedrich G, Verzini F, Haulon S, Waltham M, et al. Management of abdominal aortic aneurysms: clinical practice guidelines. Eur J Vasc Endovasc Surg. 2011;41(Suppl 1):S1–58.
Available from: https://doi.org/10.1016/j.ejvs.2010.09.011
Kent KC. Clinical practice. Abdominal aortic aneurysms. N Engl J Med. 2014;371(22):2101–8.
Available from: https://doi.org/10.1056/NEJMcp1401430
Lederle FA, Johnson GR, Wilson SE, Chute EP, Littooy FN, Bandyk D, et al. Prevalence and associations of abdominal aortic aneurysm detected through screening. Ann Intern Med. 1997;126(6):441–9.
Available from: https://doi.org/10.7326/0003-4819-126-6-199703150-00004
Svensjö S, Björck M, Wanhainen A. Update on screening for abdominal aortic aneurysm: a topical review. Eur J Vasc Endovasc Surg. 2014;48(6):659–67.
Available from: https://doi.org/10.1016/j.ejvs.2014.08.029
Wanhainen A, Verzini F, Van Herzeele I, Allaire E, Bown M, Cohnert T, et al. European Society for Vascular Surgery (ESVS) guidelines on the management of abdominal aorto-iliac artery aneurysms. Eur J Vasc Endovasc Surg. 2019;57(1):8–93. Available from: https://doi.org/10.1016/j.ejvs.2018.09.020
Forsdahl SH, Singh K, Solberg S, Jacobsen BK. Risk factors for abdominal aortic aneurysms: a 7-year prospective study. Circulation. 2009;119(16):2202–8.
Available from: https://doi.org/10.1161/CIRCULATIONAHA.108.817619
Chaikof EL, Dalman RL, Eskandari MK, Jackson BM, Lee WA, Mansour MA, et al. The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm. J Vasc Surg. 2018;67(1):2–77.e2.
Available from: https://doi.org/10.1016/j.jvs.2017.10.044
Greenhalgh RM, Brown LC, Kwong GP, Powell JT, Thompson SG; EVAR Trial Participants. Comparison of endovascular aneurysm repair with open repair in patients with abdominal aortic aneurysm (EVAR trial 1), 30-day operative mortality results. Lancet. 2004;364(9437):843–8.
Available from: https://doi.org/10.1016/S0140-6736(04)16979-1
Lederle FA, Freischlag JA, Kyriakides TC, Padberg FT Jr, Matsumura JS, Kohler TR, et al. Outcomes following endovascular vs open repair of abdominal aortic aneurysm: a randomized trial. JAMA. 2009;302(14):1535–42.
Available from: https://doi.org/10.1001/jama.2009.1426
Schanzer A, Greenberg RK, Hevelone N, Robinson WP, Eslami MH, Goldberg RJ, et al. Predictors of abdominal aortic aneurysm sac enlargement after endovascular repair. Circulation. 2011;123(24):2848–55.
Available from: https://doi.org/10.1161/CIRCULATIONAHA.110.014902
Sakalihasan N, Limet R, Defawe OD. Abdominal aortic aneurysm. Lancet. 2005;365(9470):1577–89.
Available from: https://doi.org/10.1016/S0140-6736(05)66459-8
Thompson RW, Geraghty PJ, Lee JK. Abdominal aortic aneurysms: basic mechanisms and clinical implications. Curr Probl Surg. 2002;39(3):110–230.
Available from: https://doi.org/10.1067/msg.2002.121421
Michel JB, Martin-Ventura JL, Egido J, Sakalihasan N, Treska V, Lindholt J, et al. Novel aspects of the pathogenesis of aneurysms of the abdominal aorta in humans. Cardiovasc Res. 2011;90(1):18–27.
Available from: https://doi.org/10.1093/cvr/cvq337
Jones GT, van Rij AM, Hill GB. Aneurysmal and occlusive peripheral arterial disease have different genetic risk factors. Hum Mol Genet. 2007;16(7):879–88.
Available from: https://doi.org/10.1093/hmg/ddm029
Sweeting MJ, Thompson SG, Brown LC, Greenhalgh RM; EVAR Trial Investigators. Long-term outcomes of endovascular repair of abdominal aortic aneurysm in the EVAR trial 1. N Engl J Med. 2012;367(26):2447–56.
Available from: https://doi.org/10.1056/NEJMoa1205027
Bastos Gonçalves F, Verhagen HJ. Challenges and opportunities in endovascular repair of complex abdominal aortic aneurysms. Br J Surg. 2016;103(6):563–5.
Available from: https://doi.org/10.1002/bjs.10133
Patel R, Sweeting MJ, Powell JT, Greenhalgh RM; EVAR Trial Investigators. Endovascular versus open repair of abdominal aortic aneurysm in 15-year follow-up of the UK EVAR trial 1: a randomised controlled trial. Lancet. 2016;388(10058):2366–74. Available from: https://doi.org/10.1016/S0140-6736(16)31135-7
Stather PW, Sidloff D, Dattani N, Choke E, Bown MJ, Sayers RD. Systematic review and meta-analysis of the early and late outcomes of open and endovascular repair of abdominal aortic aneurysm. Br J Surg. 2013;100(10):1294–307. Available from: https://doi.org/10.1002/bjs.9101
Lo RC, Bensley RP, Hamdan AD, Wyers M, Adams JE, Schermerhorn ML, et al. Gender differences in abdominal aortic aneurysm presentation, repair, and mortality in the Vascular Study Group of New England. J Vasc Surg. 2013;57(5):1261–8. Available from: https://doi.org/10.1016/j.jvs.2012.11.039
Shames ML, Henretta JP, Bush HL. Endovascular repair of ruptured abdominal aortic aneurysms: feasibility and early results. J Vasc Surg. 2002 Dec;36(6):1111–6.
Choke E, Cockerill GW, Wilson WR, Sayed S, Dawson J, Loftus I, et al. A review of biological factors implicated in abdominal aortic aneurysm rupture. Eur J Vasc Endovasc Surg. 2005;30(3):227–44.
Available from: https://doi.org/10.1016/j.ejvs.2005.03.009
Davis FM, Rateri DL, Daugherty A. Abdominal aortic aneurysm: novel mechanisms and therapies. Curr Opin Cardiol. 2015;30(6):566–73. Available from: https://doi.org/10.1097/HCO.0000000000000216
Wassef M, Baxter BT, Chisholm RL, Dalman RL, Fillinger MF, Heinecke J, et al. Pathogenesis of abdominal aortic aneurysms: a multidisciplinary research program supported by the U.S. National Institutes of Health. J Vasc Surg. 2001;34(4):730–8. Available from: https://doi.org/10.1067/mva.2001.116966
Claridge MW, Hobbs SD, Quick CR. Pathophysiology of abdominal aortic aneurysm progression: a review. Eur J Vasc Endovasc Surg. 2009 Mar;37(3):288–97.