Abstract
Since the advent of endovascular aortic repair (EVAR) nearly three decades ago, there
has been a paradigm shift in the treatment of the abdominal aortic aneurysm (AAA)
to favor EVAR due to its reduced operative mortality, less invasive nature, and faster
recovery times. However, more recently there has been an accumulation of data from
large meta-analyses and randomized clinical trials revealing that EVAR has no survival
benefit after approximately 2 years and is associated with substantially higher rates
of reintervention and aneurysm rupture in the long term. These findings call into
question the durability of EVAR compared with open aortic repair and emphasize the
need for surgeons to remain competent with open aortic surgery in the modern era.
This article will provide comprehensive review of a large body of literature comparing
endovascular repair to open aortic surgery for the management of AAAs, and it will
offer an overview of the open surgical repair technique for AAAs.
Keywords
abdominal aortic aneurysm - open aortic surgery - aortic repair - endovascular aortic
repair - interventional radiology
