Trend-break in Abdominal Aortic Aneurysm Repair With Decreasing Surgical Workload

Editor's Choice – European Society for Vascular Surgery (ESVS) 2019 Clinical Practice Guidelines on the Management of Abdominal Aorto-iliac Artery Aneurysms

“…10 This is particularly important in the era of rapid technical and medical development, such as the introduction of new endovascular technologies and screening. The increasing use of endovascular techniques has resulted in an ongoing change in indications with older and more comorbid patients being treated 11 and a continuing evolution of EVAR devices, which have been assessed with variable rigour for different periods of follow up. Centres performing surgical treatment of AAA should therefore preferably participate in registries which allow for continuous quality control assessment.…”

“…86 A corresponding 20e50% decline over the last two to three decades in rAAA hospital admissions and incidence of rAAA repair has been reported from many countries in Europe and the USA, despite an ageing population. 87,88,11,89 Most studies show that the prevalence is up to fourfold less in women than men. A recent systematic review of publications between 2000 and 2015 indicates that the pooled prevalence of AAA in women over 60 years was 0.7%.…”

“…Europe and the USA have shown a sustained increased utilisation of EVAR with a continued decrease in mortality and morbidity, despite older and more comorbid patients being treated by EVAR. 7,11,[349][350][351] The contemporary 30 day mortality after elective EVAR is around 1%, compared with a three to four times higher mortality after OSR. 352,11,351 The improved short-term outcome is sustained for at least five years.…”

Commentary to “Assessment of Competence in EVAR Procedures – A Novel Rating Scale Developed by the Delphi Technique”

“…In European countries a steady increase in the use of EVAR has been observed with improved outcomes. 1,2 To evaluate endovascular skills and to standardize the training and performance of trainees, the authors have developed a rating scale to assess these competences in EVAR. 3 A panel of 32 international experts have reduced a pool of 83 items to seven pivotal assessment items.…”

Mapping the Workload Associated with Intact Abdominal Aortic Aneurysm

“…Given this definition, what does the paper from Swedvasc in this issue of the journal tell us about AAA? 1 It tells us that despite the excellent Swedish AAA screening programme, 2 aneurysm repairs are not increasing at the anticipated rate. Why not?…”