Abdominal Aortic Aneurysms (AAA)

Abstract Abdominal aortic aneurysm (AAA) represents a major health problem affecting 2%–8% of males over the age of 60 and 1% of women older than 64 years. A lot of patients with AAA remain asymptomatic until the rupture occurs. Early diagnostic and prophylactic surgical intervention (open or endovascular) is essential to prevent rupture. The open repair remains the most durable intervention but the actual approach moves to endovascular aneurysmal repair (EVAR) in most countries. EVAR is nowadays considered the technique of first choice for infrarenal AAAs with suitable aortic anatomy. There are new evolving technologies making endovascular approach suitable to almost all type of aortic morphology as well as acute or chronic pathologies. Patient selection is crucial in the successful treatment of AAA. We should carefully investigate and consider the anatomy of the abdominal aorta but also the comorbidities of the patient when we establish the treatment we propose. Medium and long-term results have improved over the years both in open and endovascular approaches due to better preoperative planning and postoperative management but also to new and refined devices for endovascular treatment.