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• W1526383820 abstract "Abdominal aortic aneurysms (AAA) are a well-recognized cause of morbidity and mortality in older persons. The 20th century has lead to many overall advances in surgery and specifically the management of complex and often lethal disease processes. In the early part of last century, advances in anesthesia and critical care allowed for the surgical management of AAA via the open approach, which is to this day still considered by many to remain the gold standard of repair. In the latter part of the last century further advances and innovative thinking led to the minimally invasive endovascular treatment of many AAAs. Endovascular abdominal aortic aneurysm repair (EVAR) has pioneered the treatment of more complex aortic disease and now with greater then 20 years since its debut it is in many centers the preferred treatment. There is no longer a feasibility question; these devices have been proven to be safe and efficacious with less perioperative morbidity and mortality than traditional open repair. In an attempt to improve the world literature and make comparisons more possible amongst the many evolving studies underway globally a need for some commonality in the reporting of results was recognized. The reporting standards for AAA repair, both for endovascular and for open repair have been formulated into guidelines first extended in 1997 and then later updated in 2002. These standards outline the generally measured characteristics touched on by many of the studies reporting on the treatment of aortic aneurismal disease. Included are the common patient characteristics involved in atherosclerotic disease such as tobacco use, hyperlipidemia, hypertension, diabetes mellitus, renal insufficiency, chronic obstructive pulmonary disease, carotid occlusive disease, other associated aneurismal disease and anesthesia risk as outlined by the American Society of Anesthesiology Risk Classification (ASA). These guidelines also address characteristics unique to aneurismal disease known as the anatomical risk factors, such as aortic neck length and angulation as well as access vessels where included with a grading system. Outcome measures of clinical success and the definition of terms such as endotension and endoleak were included. The current devices have gone through several generations of advancement, alteration and modification which has addressed many of the device specific criterions that where offered and for the most part has addressed, and continue to address these limitations as innovation in the field continues. With further advances and longer length follow up periods many of the earlier unanswered questions are being addressed however in doing so new questions have arisen and the persistent question since the inception of EVAR remains a point of controversy to this day," @default.
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• W1526383820 date "2011-12-16" @default.
• W1526383820 modified "2023-09-24" @default.
• W1526383820 title "Abdominal Aortic Aneurysms: Changing Paradigms in Treatment" @default.
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• W1526383820 doi "https://doi.org/10.5772/17476" @default.
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