European Society for Vascular Surgery (ESVS) 2019 Clinical Practice Guidelines on the Management of Abdominal Aortoiliac Artery Aneurysms

The European Journal of Vascular and Endovascular Surgery published The European Society for Vascular Surgery (ESVS) 2019 clinical practice guidelines on the management of abdominal aortoiliac artery aneurysms. This is an important reference for cardiothoracic and vascular surgeons who are engaged in the care of patients with aortic disease.

The document covers several topics that were not addressed in the 2011 guidelines, including: 1) juxtarenal abdominal aortic aneurysm (AAA), isolated iliac aneurysms, mycotic and inflammatory aneurysms, and concomitant malignant disease; 2) new treatment concepts, such as fenestrated endovascular aneurysm repair (EVAR), chimney EVAR, and endovascular aneurysm sealing; 3) service standards and logistics of importance, including surgical volume requirements and acceptable waiting time for surgery; and 4) the patient's perspective – a topic that is included for the first time in an ESVS guideline.

Several updated recommendations have been made based on new data or evidence for already established topics, including: 1) recommendations on an EVAR-first strategy for ruptured AAA; 2) a stratified, less frequent follow-up regimen after EVAR; and 3) an updated surveillance protocol for small AAAs and subaneurysms.