Although aneurysm-related mortality and mortality from other causes were similar in both study groups, concomitant iliac artery aneurysms in AAA patients were associated with an increased incidence of distal type I endoleak, iliac limb occlusion, and aneurysm rupture. Therefore, caution is warranted, and efforts should be made to avoid procedural mishaps.

The long-term follow-up results of the endoscopic division of perforating veins are comparable with those of the open division of perforating veins (modified Linton procedure).

The endovenous catheter should not be used more than 5 to 10 cm below the knee to prevent saphenous nerve damage. Performance of the procedure with bloodlessness is preferable. A result of 88% of successfully treated LSV segments indicates a promising alternative for surgical stripping of the LSV.

This study supports applications of the Dutch AVVQ in HR-QOL measurement in patients with venous disease in the Netherlands and the Flemish speaking part of Belgium.

This study established the use of the Dutch translated AVVQ as a valid, health-related quality of life (QOL) questionnaire for measuring QOL before and after treatment in patients with clinical-severity classes 1-6 venous disease of the leg.

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WHAT THIS PAPER ADDSThis paper provides an overview of trends in peri-operative outcomes of patients who underwent standard endovascular aneurysm repair (EVAR) or open surgical repair (OSR) for an intact abdominal aortic aneurysm between 2014 and 2019 and who were registered in a mandatory nationwide registry. This study shows that all peri-operative outcomes (mortality, major complications, and textbook outcome) of EVAR and OSR for intact abdominal aortic aneurysms have improved since 2014, except for peri-operative mortality following EVAR which remained unchanged.Objective: The Dutch Surgical Aneurysm Audit (DSAA) initiative was established in 2013 to monitor and improve nationwide outcomes of aortic aneurysm surgery. The objective of this study was to examine whether outcomes of surgery for intact abdominal aortic aneurysms (iAAA) have improved over time. Methods: Patients who underwent primary repair of an iAAA by standard endovascular (EVAR) or open surgical repair (OSR) between 2014 and 2019 were selected from the DSAA for inclusion. The primary outcome was perioperative mortality trend per year, stratified by OSR and EVAR. Secondary outcomes were trends per year in major complications, textbook outcome (TbO), and characteristics of treated patients. The trends per year were evaluated and reported in odds ratios per year. Results: In this study, 11 624 patients (74.8%) underwent EVAR and 3 908 patients (25.2%) underwent OSR. For EVAR, after adjustment for confounding factors, there was no improvement in peri-operative mortality (aOR [adjusted odds ratio] 1.06, 95% CI 0.94 e 1.20), while major complications decreased