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Patients with abdominal aortic aneurysm

Aortic aneurysm Graft Aortic aneurysm

Stent graft

Surveillance (See aneurysm follow-up algorithm) N

N

Low/medium High Prohibitive

Either of the following:

Life expectancy •2 years

Operative mortality risk

Elective repair Anatomy appropriate for EVAR

Open repair

(Class I)

If suitable anatomy, EVAR (Class IIa) Optimal medical

treatment

Elective repair

(Class III)

EVAR (Class IIa)

Fusiform AAA ≥55 mm (men), ≥50 mm (women) Saccular aneurysm •45 mm N

Y

Y

Y

A B

Figure 26 Algorithm for individual decision-making process in the treatment of patients with abdominal aortic aneurysm. (A) Illustration of open repair (graft). (B) Illustration of endovascular treatment (EVAR). AAA, abdominal aortic aneurysm; EVAR, endovascular aortic aneurysm repair. Downloaded from academic.oup.com/eurheartj/article/45/36/3538/7738955 by guest on 07 October 2026