S. Yousefi

Thrombus in the non-aneurysmal, non-atherosclerotic descending thoracic aorta--an unusual source of arterial embolism.

INTRODUCTION Mural thrombus of the thoracic aorta is a rare clinical finding in the absence of aneurysm or atherosclerosis. METHODS The medical records of all patients diagnosed with a thrombus of a non-aneurysmatic and non-atherosclerotic descending thoracic aorta (NAADTA) and treated by the senior author between 04/1997 and 04/2010 were reviewed. RESULTS Eight patients with mural thrombus of the NAADTA were identified. Arterial embolism was the main clinical finding in all cases and involved the lower extremities (n = 6), mesenteric (n = 3) or renal arteries (n = 2). Hypercoagulable disorders were present in 3 cases and a concurrent malignancy in another 3. Two patients underwent open surgery while 4 patients were treated conservatively with anticoagulation. Of the remaining 2 patients, one was treated with a thoracic stent-graft and aorto-biiliac bypass and the other one with transfemoral thrombectomy. Technical success was achieved in all surgical cases and thrombus resolution or stable disease in the conservative management group. No thrombus recurrence was observed during a mean follow-up of 49 months. CONCLUSION The management of mural thrombus in NAADTA represents a challenge, especially in case of malignant disease or hypercoagulable disorder as a potential underlying pathology and should be individualized. Although no consensus exists in the literature, therapeutic anticoagulation is proposed as first-line therapy. The indication for surgical intervention results from contraindication to anticoagulation, mobile thrombus or recurrent embolism. Whenever possible, endovascular therapy should be preferred.

Treatment of internal iliac artery aneurysms: single‐centre experience

Background:  The aim of the present study was to analyse the short‐term results of treatment of internal iliac artery aneurysms (IIAA).

Management von Komplikationen nach Revaskularisation wegen peripherer arterieller Verschlusskrankheit

ZusammenfassungHintergrundKomplikationen gefährden den Erfolg einer Revaskularisation zur Behandlung der peripheren arteriellen Verschlusskrankheit (paVK) und müssen daher primär vermieden oder bei Auftreten effektiv behandelt werden.Ziel der ArbeitEs soll eine Übersicht über die möglichen Komplikationen nach Revaskularisation bei paVK und deren Management erfolgen.Material und MethodenEine systematische Literaturrecherche wurde in PubMed und Medline unter besonderer Berücksichtigung von aktuellen Publikationen vorgenommen.ErgebnisseDie Revaskularisation zur Therapie der paVK kann prinzipiell offen, endovaskulär oder als Kombination beider Methoden (Hybridoperation) erfolgen. Das Spektrum möglicher Komplikationen unterscheidet sich dementsprechend. Es können Blutungs-, ischämische und systemische oder auch vaskuläre von nichtvaskulären Komplikationen unterschieden werden. Das optimale Komplikationsmanagement beginnt mit der primären Prophylaxe und beinhaltet weiter die zeitgerechte Diagnostik und Therapie von bereits eingetretenen Komplikationen. Die beste Prophylaxe besteht in einer hohen Qualität von Indikation und Durchführung der Revaskularisation.DiskussionFür den Erfolg der Revaskularisation zur Behandlung der paVK ist ein optimales Komplikationsmanagement von entscheidender Bedeutung.AbstractBackgroundComplications are a threat to successful revascularization for treatment of perpheral arterial occlusive disease (PAOD) and must, therefore, be either primarily prevented or effectively treated after having occurred.ObjectivesThe aim of this article is to give a survey of possible complications after revascularization for treatment of PAOD and their management.Material and methodsA systematic literature review was performed in PubMed and Medline. The analysis mainly considered recent publications with a higher level of evidence.ResultsRevascularization for treatment of PAOD can basically be performed by an open surgical approach, an endovascular approach or as a combination of both methods (hybrid operation). The spectrum of possible complications varies accordingly. A differentiation can be made between bleeding, ischemic and systemic complications as well as between vascular and non-vascular complications. Optimal management of complications begins with primary prophylaxis and further includes a timely diagnosis and treatment of established complications. The best prophylaxis consists of a high quality of indications and performance of revascularization.ConclusionOptimal management of complications is essential and of utmost importance for successful revascularization to treat PAOD.BACKGROUND Complications are a threat to successful revascularization for treatment of perpheral arterial occlusive disease (PAOD) and must, therefore, be either primarily prevented or effectively treated after having occurred. OBJECTIVES The aim of this article is to give a survey of possible complications after revascularization for treatment of PAOD and their management. MATERIAL AND METHODS A systematic literature review was performed in PubMed and Medline. The analysis mainly considered recent publications with a higher level of evidence. RESULTS Revascularization for treatment of PAOD can basically be performed by an open surgical approach, an endovascular approach or as a combination of both methods (hybrid operation). The spectrum of possible complications varies accordingly. A differentiation can be made between bleeding, ischemic and systemic complications as well as between vascular and non-vascular complications. Optimal management of complications begins with primary prophylaxis and further includes a timely diagnosis and treatment of established complications. The best prophylaxis consists of a high quality of indications and performance of revascularization. CONCLUSION Optimal management of complications is essential and of utmost importance for successful revascularization to treat PAOD.

Management von Komplikationen nach Revaskularisation wegen peripherer arterieller Verschlusskrankheit@@@Management of complications after revascularization due to peripheral arterial occlusive disease: Prophylaxe und konsequente adäquate Therapie nach zeitgerechter Diagnostik@@@Prophylaxis and consistent adequate therapy after timely diagnostics

ZusammenfassungHintergrundKomplikationen gefährden den Erfolg einer Revaskularisation zur Behandlung der peripheren arteriellen Verschlusskrankheit (paVK) und müssen daher primär vermieden oder bei Auftreten effektiv behandelt werden.Ziel der ArbeitEs soll eine Übersicht über die möglichen Komplikationen nach Revaskularisation bei paVK und deren Management erfolgen.Material und MethodenEine systematische Literaturrecherche wurde in PubMed und Medline unter besonderer Berücksichtigung von aktuellen Publikationen vorgenommen.ErgebnisseDie Revaskularisation zur Therapie der paVK kann prinzipiell offen, endovaskulär oder als Kombination beider Methoden (Hybridoperation) erfolgen. Das Spektrum möglicher Komplikationen unterscheidet sich dementsprechend. Es können Blutungs-, ischämische und systemische oder auch vaskuläre von nichtvaskulären Komplikationen unterschieden werden. Das optimale Komplikationsmanagement beginnt mit der primären Prophylaxe und beinhaltet weiter die zeitgerechte Diagnostik und Therapie von bereits eingetretenen Komplikationen. Die beste Prophylaxe besteht in einer hohen Qualität von Indikation und Durchführung der Revaskularisation.DiskussionFür den Erfolg der Revaskularisation zur Behandlung der paVK ist ein optimales Komplikationsmanagement von entscheidender Bedeutung.AbstractBackgroundComplications are a threat to successful revascularization for treatment of perpheral arterial occlusive disease (PAOD) and must, therefore, be either primarily prevented or effectively treated after having occurred.ObjectivesThe aim of this article is to give a survey of possible complications after revascularization for treatment of PAOD and their management.Material and methodsA systematic literature review was performed in PubMed and Medline. The analysis mainly considered recent publications with a higher level of evidence.ResultsRevascularization for treatment of PAOD can basically be performed by an open surgical approach, an endovascular approach or as a combination of both methods (hybrid operation). The spectrum of possible complications varies accordingly. A differentiation can be made between bleeding, ischemic and systemic complications as well as between vascular and non-vascular complications. Optimal management of complications begins with primary prophylaxis and further includes a timely diagnosis and treatment of established complications. The best prophylaxis consists of a high quality of indications and performance of revascularization.ConclusionOptimal management of complications is essential and of utmost importance for successful revascularization to treat PAOD.BACKGROUND Complications are a threat to successful revascularization for treatment of perpheral arterial occlusive disease (PAOD) and must, therefore, be either primarily prevented or effectively treated after having occurred. OBJECTIVES The aim of this article is to give a survey of possible complications after revascularization for treatment of PAOD and their management. MATERIAL AND METHODS A systematic literature review was performed in PubMed and Medline. The analysis mainly considered recent publications with a higher level of evidence. RESULTS Revascularization for treatment of PAOD can basically be performed by an open surgical approach, an endovascular approach or as a combination of both methods (hybrid operation). The spectrum of possible complications varies accordingly. A differentiation can be made between bleeding, ischemic and systemic complications as well as between vascular and non-vascular complications. Optimal management of complications begins with primary prophylaxis and further includes a timely diagnosis and treatment of established complications. The best prophylaxis consists of a high quality of indications and performance of revascularization. CONCLUSION Optimal management of complications is essential and of utmost importance for successful revascularization to treat PAOD.

[Management of complications after revascularization due to peripheral arterial occlusive disease : Prophylaxis and consistent adequate therapy after timely diagnostics].

ZusammenfassungHintergrundKomplikationen gefährden den Erfolg einer Revaskularisation zur Behandlung der peripheren arteriellen Verschlusskrankheit (paVK) und müssen daher primär vermieden oder bei Auftreten effektiv behandelt werden.Ziel der ArbeitEs soll eine Übersicht über die möglichen Komplikationen nach Revaskularisation bei paVK und deren Management erfolgen.Material und MethodenEine systematische Literaturrecherche wurde in PubMed und Medline unter besonderer Berücksichtigung von aktuellen Publikationen vorgenommen.ErgebnisseDie Revaskularisation zur Therapie der paVK kann prinzipiell offen, endovaskulär oder als Kombination beider Methoden (Hybridoperation) erfolgen. Das Spektrum möglicher Komplikationen unterscheidet sich dementsprechend. Es können Blutungs-, ischämische und systemische oder auch vaskuläre von nichtvaskulären Komplikationen unterschieden werden. Das optimale Komplikationsmanagement beginnt mit der primären Prophylaxe und beinhaltet weiter die zeitgerechte Diagnostik und Therapie von bereits eingetretenen Komplikationen. Die beste Prophylaxe besteht in einer hohen Qualität von Indikation und Durchführung der Revaskularisation.DiskussionFür den Erfolg der Revaskularisation zur Behandlung der paVK ist ein optimales Komplikationsmanagement von entscheidender Bedeutung.AbstractBackgroundComplications are a threat to successful revascularization for treatment of perpheral arterial occlusive disease (PAOD) and must, therefore, be either primarily prevented or effectively treated after having occurred.ObjectivesThe aim of this article is to give a survey of possible complications after revascularization for treatment of PAOD and their management.Material and methodsA systematic literature review was performed in PubMed and Medline. The analysis mainly considered recent publications with a higher level of evidence.ResultsRevascularization for treatment of PAOD can basically be performed by an open surgical approach, an endovascular approach or as a combination of both methods (hybrid operation). The spectrum of possible complications varies accordingly. A differentiation can be made between bleeding, ischemic and systemic complications as well as between vascular and non-vascular complications. Optimal management of complications begins with primary prophylaxis and further includes a timely diagnosis and treatment of established complications. The best prophylaxis consists of a high quality of indications and performance of revascularization.ConclusionOptimal management of complications is essential and of utmost importance for successful revascularization to treat PAOD.BACKGROUND Complications are a threat to successful revascularization for treatment of perpheral arterial occlusive disease (PAOD) and must, therefore, be either primarily prevented or effectively treated after having occurred. OBJECTIVES The aim of this article is to give a survey of possible complications after revascularization for treatment of PAOD and their management. MATERIAL AND METHODS A systematic literature review was performed in PubMed and Medline. The analysis mainly considered recent publications with a higher level of evidence. RESULTS Revascularization for treatment of PAOD can basically be performed by an open surgical approach, an endovascular approach or as a combination of both methods (hybrid operation). The spectrum of possible complications varies accordingly. A differentiation can be made between bleeding, ischemic and systemic complications as well as between vascular and non-vascular complications. Optimal management of complications begins with primary prophylaxis and further includes a timely diagnosis and treatment of established complications. The best prophylaxis consists of a high quality of indications and performance of revascularization. CONCLUSION Optimal management of complications is essential and of utmost importance for successful revascularization to treat PAOD.

Aneurysmen der Bauchaorta und der Beckenarterien@@@Aneurysms of the abdominal aorta and iliac arteries: Paradigmenwechsel – operative Therapie, wenn möglich endovaskulär?@@@Paradigm shift – operative therapy, if possible endovascular?

BACKGROUND Therapy of abdominal aortic aneurysms (AAA) is currently based on a high level of evidence. This is not true in the same manner for iliac artery aneurysms (IAA) which are frequently associated with AAAs and occur only rarely as isolated lesions. The therapeutic principles apply in the same way to both aneurysm locations. OBJECTIVES New findings, improved perioperative care and the rapid development of minimally invasive techniques require a constant update which is the aim of this article concerning the therapy of AAAs and IAAs. MATERIAL AND METHODS A systematic literature review was performed in PubMed and Medline and priority was given to recent publications with a high level of evidence. RESULTS Endovascular aneurysm repair (EVAR) and open aneurysm repair (OAR) result in a similar long-term survival. The perioperative survival advantage with EVAR persists only during medium-term postoperative courses. The reintervention rate after EVAR is substantially higher compared to OAR. For older patients and those who are considered unfit for OAR the expected benefits from EVAR has not been proven to date. Aneurysmal ruptures after EVAR demonstrate that a life-long surveillance of these patients is necessary. CONCLUSION Therapy of AAAs and IAAs is increasingly being performed by EVAR. Even the majority of complex aneurysms are amenable to minimally invasive treatment. Nevertheless, indications for OAR continue to exist. Screening for AAAs results in a decrease of aneurysmal ruptures for which EVAR is also gaining importance.ZusammenfassungHintergrundDie Therapie des Bauchaortenaneurysmas („abdominal aortic aneurysm“, AAA) ist heute auf hohem Evidenzniveau gesichert. Das gilt nicht in gleicher Weise für das Beckenarterienaneurysma („iliac artery aneurysm“, IAA). IAAs sind häufig mit einem AAA assoziiert und treten nur selten isoliert auf. Therapieprinzipien gelten für beide Aneurysmalokalisationen in analoger Weise.Ziel der ArbeitNeue Erkenntnisse, Fortschritte der perioperativen Medizin und die rasante Entwicklung der minimal-invasiven Technik erfordern regelmäßig eine aktuelle Standortbestimmung (Update), die in dieser Arbeit zur Therapie des AAA und IAA erfolgen soll.Material und MethodenEine systematische Literaturrecherche wurde in PubMed und Medline vorgenommen. Dabei wurden vorrangig rezente Publikationen auf höherem Evidenzniveau berücksichtigt.ErgebnisseEVAR („endovascular aneurysm repair“) und OAR („open aneurym repair“) sind gleichwertige Methoden zur Behandlung des AAA bezüglich des Langzeitüberlebens der Patienten. Ein perioperativer Überlebensvorteil nach EVAR persistiert lediglich mittelfristig postoperativ. Die Reinterventionsrate nach EVAR ist gegenüber OAR deutlich erhöht. Für ältere Patienten und solche, für die eine OAR nicht mehr infrage kommt, konnte der erwartete Vorteil der EVAR bis dato nicht bewiesen werden. Aneurysmarupturen nach EVAR zeigen, dass eine lebenslange Kontrolle dieser Patienten erforderlich ist.DiskussionDie elektive Therapie des AAA und IAA erfolgt zunehmend endovaskulär (EVAR). Auch komplexe Aneurysmen sind überwiegend minimal-invasiv behandelbar. Dennoch existiert auch weiterhin die Indikation zur offenen Aneurysmaausschaltung (OAR). Ein AAA-Screening führt zu einer Verminderung von Aneurysmarupturen, für die die EVAR ebenfalls zunehmende Bedeutung erlangt.AbstractBackgroundTherapy of abdominal aortic aneurysms (AAA) is currently based on a high level of evidence. This is not true in the same manner for iliac artery aneurysms (IAA) which are frequently associated with AAAs and occur only rarely as isolated lesions. The therapeutic principles apply in the same way to both aneurysm locations.ObjectivesNew findings, improved perioperative care and the rapid development of minimally invasive techniques require a constant update which is the aim of this article concerning the therapy of AAAs and IAAs.Material and methodsA systematic literature review was performed in PubMed and Medline and priority was given to recent publications with a high level of evidence.ResultsEndovascular aneurysm repair (EVAR) and open aneurysm repair (OAR) result in a similar long-term survival. The perioperative survival advantage with EVAR persists only during medium-term postoperative courses. The reintervention rate after EVAR is substantially higher compared to OAR. For older patients and those who are considered unfit for OAR the expected benefits from EVAR has not been proven to date. Aneurysmal ruptures after EVAR demonstrate that a life-long surveillance of these patients is necessary.ConclusionTherapy of AAAs and IAAs is increasingly being performed by EVAR. Even the majority of complex aneurysms are amenable to minimally invasive treatment. Nevertheless, indications for OAR continue to exist. Screening for AAAs results in a decrease of aneurysmal ruptures for which EVAR is also gaining importance.

[Aneurysms of the abdominal aorta and iliac arteries: paradigm shift - operative therapy, if possible endovascular?].

BACKGROUND Therapy of abdominal aortic aneurysms (AAA) is currently based on a high level of evidence. This is not true in the same manner for iliac artery aneurysms (IAA) which are frequently associated with AAAs and occur only rarely as isolated lesions. The therapeutic principles apply in the same way to both aneurysm locations. OBJECTIVES New findings, improved perioperative care and the rapid development of minimally invasive techniques require a constant update which is the aim of this article concerning the therapy of AAAs and IAAs. MATERIAL AND METHODS A systematic literature review was performed in PubMed and Medline and priority was given to recent publications with a high level of evidence. RESULTS Endovascular aneurysm repair (EVAR) and open aneurysm repair (OAR) result in a similar long-term survival. The perioperative survival advantage with EVAR persists only during medium-term postoperative courses. The reintervention rate after EVAR is substantially higher compared to OAR. For older patients and those who are considered unfit for OAR the expected benefits from EVAR has not been proven to date. Aneurysmal ruptures after EVAR demonstrate that a life-long surveillance of these patients is necessary. CONCLUSION Therapy of AAAs and IAAs is increasingly being performed by EVAR. Even the majority of complex aneurysms are amenable to minimally invasive treatment. Nevertheless, indications for OAR continue to exist. Screening for AAAs results in a decrease of aneurysmal ruptures for which EVAR is also gaining importance.ZusammenfassungHintergrundDie Therapie des Bauchaortenaneurysmas („abdominal aortic aneurysm“, AAA) ist heute auf hohem Evidenzniveau gesichert. Das gilt nicht in gleicher Weise für das Beckenarterienaneurysma („iliac artery aneurysm“, IAA). IAAs sind häufig mit einem AAA assoziiert und treten nur selten isoliert auf. Therapieprinzipien gelten für beide Aneurysmalokalisationen in analoger Weise.Ziel der ArbeitNeue Erkenntnisse, Fortschritte der perioperativen Medizin und die rasante Entwicklung der minimal-invasiven Technik erfordern regelmäßig eine aktuelle Standortbestimmung (Update), die in dieser Arbeit zur Therapie des AAA und IAA erfolgen soll.Material und MethodenEine systematische Literaturrecherche wurde in PubMed und Medline vorgenommen. Dabei wurden vorrangig rezente Publikationen auf höherem Evidenzniveau berücksichtigt.ErgebnisseEVAR („endovascular aneurysm repair“) und OAR („open aneurym repair“) sind gleichwertige Methoden zur Behandlung des AAA bezüglich des Langzeitüberlebens der Patienten. Ein perioperativer Überlebensvorteil nach EVAR persistiert lediglich mittelfristig postoperativ. Die Reinterventionsrate nach EVAR ist gegenüber OAR deutlich erhöht. Für ältere Patienten und solche, für die eine OAR nicht mehr infrage kommt, konnte der erwartete Vorteil der EVAR bis dato nicht bewiesen werden. Aneurysmarupturen nach EVAR zeigen, dass eine lebenslange Kontrolle dieser Patienten erforderlich ist.DiskussionDie elektive Therapie des AAA und IAA erfolgt zunehmend endovaskulär (EVAR). Auch komplexe Aneurysmen sind überwiegend minimal-invasiv behandelbar. Dennoch existiert auch weiterhin die Indikation zur offenen Aneurysmaausschaltung (OAR). Ein AAA-Screening führt zu einer Verminderung von Aneurysmarupturen, für die die EVAR ebenfalls zunehmende Bedeutung erlangt.AbstractBackgroundTherapy of abdominal aortic aneurysms (AAA) is currently based on a high level of evidence. This is not true in the same manner for iliac artery aneurysms (IAA) which are frequently associated with AAAs and occur only rarely as isolated lesions. The therapeutic principles apply in the same way to both aneurysm locations.ObjectivesNew findings, improved perioperative care and the rapid development of minimally invasive techniques require a constant update which is the aim of this article concerning the therapy of AAAs and IAAs.Material and methodsA systematic literature review was performed in PubMed and Medline and priority was given to recent publications with a high level of evidence.ResultsEndovascular aneurysm repair (EVAR) and open aneurysm repair (OAR) result in a similar long-term survival. The perioperative survival advantage with EVAR persists only during medium-term postoperative courses. The reintervention rate after EVAR is substantially higher compared to OAR. For older patients and those who are considered unfit for OAR the expected benefits from EVAR has not been proven to date. Aneurysmal ruptures after EVAR demonstrate that a life-long surveillance of these patients is necessary.ConclusionTherapy of AAAs and IAAs is increasingly being performed by EVAR. Even the majority of complex aneurysms are amenable to minimally invasive treatment. Nevertheless, indications for OAR continue to exist. Screening for AAAs results in a decrease of aneurysmal ruptures for which EVAR is also gaining importance.

Aneurysmen der Bauchaorta und der Beckenarterien

BACKGROUND Therapy of abdominal aortic aneurysms (AAA) is currently based on a high level of evidence. This is not true in the same manner for iliac artery aneurysms (IAA) which are frequently associated with AAAs and occur only rarely as isolated lesions. The therapeutic principles apply in the same way to both aneurysm locations. OBJECTIVES New findings, improved perioperative care and the rapid development of minimally invasive techniques require a constant update which is the aim of this article concerning the therapy of AAAs and IAAs. MATERIAL AND METHODS A systematic literature review was performed in PubMed and Medline and priority was given to recent publications with a high level of evidence. RESULTS Endovascular aneurysm repair (EVAR) and open aneurysm repair (OAR) result in a similar long-term survival. The perioperative survival advantage with EVAR persists only during medium-term postoperative courses. The reintervention rate after EVAR is substantially higher compared to OAR. For older patients and those who are considered unfit for OAR the expected benefits from EVAR has not been proven to date. Aneurysmal ruptures after EVAR demonstrate that a life-long surveillance of these patients is necessary. CONCLUSION Therapy of AAAs and IAAs is increasingly being performed by EVAR. Even the majority of complex aneurysms are amenable to minimally invasive treatment. Nevertheless, indications for OAR continue to exist. Screening for AAAs results in a decrease of aneurysmal ruptures for which EVAR is also gaining importance.ZusammenfassungHintergrundDie Therapie des Bauchaortenaneurysmas („abdominal aortic aneurysm“, AAA) ist heute auf hohem Evidenzniveau gesichert. Das gilt nicht in gleicher Weise für das Beckenarterienaneurysma („iliac artery aneurysm“, IAA). IAAs sind häufig mit einem AAA assoziiert und treten nur selten isoliert auf. Therapieprinzipien gelten für beide Aneurysmalokalisationen in analoger Weise.Ziel der ArbeitNeue Erkenntnisse, Fortschritte der perioperativen Medizin und die rasante Entwicklung der minimal-invasiven Technik erfordern regelmäßig eine aktuelle Standortbestimmung (Update), die in dieser Arbeit zur Therapie des AAA und IAA erfolgen soll.Material und MethodenEine systematische Literaturrecherche wurde in PubMed und Medline vorgenommen. Dabei wurden vorrangig rezente Publikationen auf höherem Evidenzniveau berücksichtigt.ErgebnisseEVAR („endovascular aneurysm repair“) und OAR („open aneurym repair“) sind gleichwertige Methoden zur Behandlung des AAA bezüglich des Langzeitüberlebens der Patienten. Ein perioperativer Überlebensvorteil nach EVAR persistiert lediglich mittelfristig postoperativ. Die Reinterventionsrate nach EVAR ist gegenüber OAR deutlich erhöht. Für ältere Patienten und solche, für die eine OAR nicht mehr infrage kommt, konnte der erwartete Vorteil der EVAR bis dato nicht bewiesen werden. Aneurysmarupturen nach EVAR zeigen, dass eine lebenslange Kontrolle dieser Patienten erforderlich ist.DiskussionDie elektive Therapie des AAA und IAA erfolgt zunehmend endovaskulär (EVAR). Auch komplexe Aneurysmen sind überwiegend minimal-invasiv behandelbar. Dennoch existiert auch weiterhin die Indikation zur offenen Aneurysmaausschaltung (OAR). Ein AAA-Screening führt zu einer Verminderung von Aneurysmarupturen, für die die EVAR ebenfalls zunehmende Bedeutung erlangt.AbstractBackgroundTherapy of abdominal aortic aneurysms (AAA) is currently based on a high level of evidence. This is not true in the same manner for iliac artery aneurysms (IAA) which are frequently associated with AAAs and occur only rarely as isolated lesions. The therapeutic principles apply in the same way to both aneurysm locations.ObjectivesNew findings, improved perioperative care and the rapid development of minimally invasive techniques require a constant update which is the aim of this article concerning the therapy of AAAs and IAAs.Material and methodsA systematic literature review was performed in PubMed and Medline and priority was given to recent publications with a high level of evidence.ResultsEndovascular aneurysm repair (EVAR) and open aneurysm repair (OAR) result in a similar long-term survival. The perioperative survival advantage with EVAR persists only during medium-term postoperative courses. The reintervention rate after EVAR is substantially higher compared to OAR. For older patients and those who are considered unfit for OAR the expected benefits from EVAR has not been proven to date. Aneurysmal ruptures after EVAR demonstrate that a life-long surveillance of these patients is necessary.ConclusionTherapy of AAAs and IAAs is increasingly being performed by EVAR. Even the majority of complex aneurysms are amenable to minimally invasive treatment. Nevertheless, indications for OAR continue to exist. Screening for AAAs results in a decrease of aneurysmal ruptures for which EVAR is also gaining importance.