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Document Reviewers: Alessia Gimelli, (CPG Review Co-ordinator) (Italy), Jean-Baptiste Ricco, (CPG Review Co-ordinator) (France), Elena Arbelo (Spain), Christian-Alexander Behrendt (Germany), Michael Böhm (Germany), Michael A. Borger (Germany), Margarita Brida (Croatia), Sergio Buccheri (Sweden), Gill Louise Buchanan (United Kingdom), Christina Christersson (Sweden), Gert J. de Borst (Netherlands), Marco De Carlo (Italy), Roman Gottardi (Austria), Lydia Hanna (United Kingdom), Lynne Hinterbuchner (Austria), Borja Ibanez (Spain), Ignatios Ikonomidis (Greece), Stefan James (Sweden), Thomas Kahan (Sweden), Klaus Kallenbach2 (Luxemburg), Lars Køber (Denmark), Konstantinos C. Koskinas (Switzerland), Juraj Madaric1 (Slovakia), Blandine Maurel (France), John William McEvoy (Ireland), Gil Meltzer (Israel), Borislava Mihaylova (United Kingdom), Richard Mindham (United Kingdom), Ioana Mozos (Romania), Jens Cosedis Nielsen (Denmark), Eva Prescott (Denmark), Amina Rakisheva (Kazakhstan), Barbara Rantner (Germany), Bianca Rocca (Italy), Xavier Rossello (Spain), Jean Paul Schmid (Switzerland), Daniel Staub (Switzerland), Sabine Steiner (Germany), Isabella Sudano (Switzerland), Martin Teraa (Netherlands), Ilonca Vaartjes (Netherlands), Rafael Vidal-Perez (Spain), Christiaan Vrints (Belgium), and Katja Zeppenfeld (Netherlands) All experts involved in the development of these guidelines have submitted declarations of interest which are reported in a supplementary document to the guidelines. See the European Heart Journal online or https://www.escardio.org/Guidelines for supplementary documents as well as evidence tables Disclaimer. The ESC Guidelines represent the views of the ESC and were produced after careful consideration of the scientific and medical knowledge and the evidence available at the time of their publication. The ESC is not responsible in the event of any contradiction, discrepancy and/or ambiguity between the ESC Guidelines and any other official recommendations or guidelines issued by the relevant public health authorities, in particular in relation to good use of healthcare or therapeutic strategies. Health professionals are encouraged to take the ESC Guidelines fully into account when exercising their clinical judgment, as well as in the determination and the implementation of preventive, diagnostic or therapeutic medical strategies; however, the ESC Guidelines do not override, in any way whatsoever, the individual responsibility of health professionals to make appropriate and accurate decisions in consideration of each patient’s health condition and in consultation with that patient and, where appropriate and/or necessary, the patient’s caregiver. Nor do the ESC Guidelines exempt health professionals from taking into full and careful consideration the relevant official updated recommendations or guidelines issued by the competent public health authorities, in order to manage each patient’s case in light of the scientifically accepted data pursuant to their respective ethical and professional obligations. It is also the health professional’s responsibility to verify the applicable rules and regulations relating to drugs and medical devices at the time of prescription. The ESC warns readers that the technical language may be misinterpreted and declines any responsibility in this respect. Permissions. The content of these European Society of Cardiology (ESC) Guidelines has been published for personal and educational use only. No commercial use is authorized. No part of the ESC Guidelines may be translated or reproduced in any form without written permission from the ESC. Permissions can be obtained upon submission of a written request to Oxford University Press, the publisher of the European Heart Journal and the party authorized to handle such permissions on behalf of the ESC (journals.permissions@oup.com). - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Keywords Guidelines • Acute aortic syndrome • Aortic aneurysm • Aortic atherosclerosis • Aortic dissection • Aortic surgery • Carotid artery disease • Chronic limb-threatening ischaemia • Endovascular repair • Exercise • Genetic aortic diseases • Intramural haematoma • Lower extremity artery disease • Penetrating atherosclerotic ulcer • Peripheral arterial disease • Polyvascular disease • Renal artery disease ESC Guidelines 3539 Downloaded from academic.oup.com/eurheartj/article/45/36/3538/7738955 by guest on 07 October 2026