Choice of treatment in patients with abdominal aortic aneurysm

Abstract

Patients with abdominal aortic aneurysm (ААА), candidates for operative treatment, should make their own choice in regard to the management of their disease. The physician in charge should discuss matters with them and their relatives and explain both types of possible treatments, considering pros and cons. Only after that explanation should doctors offer the right option according to their knowledge and experience.

Intentionally expressing preference for one option over the other in advance is not correct, because if postoperative problems occur, an explanation must be delivered to the patients on not presenting all details in advance.

One should have in mind that the AAA surgery without ischaemia of the legs or abdominal pain is not mandatory, but prophylactic. If the well calculated risk from the operation exceeds the potential benefit, patients may be treated conservatively.  

The perfect performance of the open surgery or endovascular abdominal aneurysm repair (EVAR) has also pros and cons. We have tried to present in detail the criteria according to which these two methods are assessed, and thus be of help to the physician in charge and the patient when making the right choice.