General Principles

in Aortic Aneurysmal Disease

Applied

Type

Reinforcement

Confidence

90%

Created

Mar 26, 2026

Evidence

1 source

Rationale

The ESVS 2025 Clinical Practice Guidelines on Vascular Trauma provide high-level evidence for the management of vascular emergencies. Integrating these guidelines into the 'General Principles' section reinforces the existing recommendations for regionalized care, permissive hypotension, and massive transfusion protocols. This addition also ensures geographic balance by pairing the existing US (SVS) guidelines with the latest European (ESVS) equivalents. Abbreviations were expanded on first use as per the instructions.

Evidence

Wahlgren CM et al. Editor's Choice -- European Society for Vascular Surgery (ESVS) 2025 Clinical Practice Guidelines on the Management of Vascular Trauma. Eur J Vasc Endovasc Surg. 2025. PMID: 39809666.
Verified source
PubMedDOI

Content Changes

* rAAA,Ruptured rTAA,abdominal aortic aneurysms (rAAA), ruptured thoracic aortic aneurysms (rTAA), and ruptured iliac aneurysms are life-threatening emergencies with overall mortality often >50% including prehospital deaths [@powell2014-improve].
* Regionalized pathways with 24/7 computed tomography angiography (CTA), endovascular capability, blood products, and hybrid ORsoperating rooms (ORs) are recommended [@svs2018].[@svs2018; @esvs2025-editors].
* Initial management: permissive hypotension, massive transfusion protocol,protocol (MTP), and rapid CT-based triage in stable or semi-stable patients; an endovascular aneurysm repair (EVAR)-first strategy is feasible in many rAAA and supported by randomized strategy data [@improve2017].[@improve2017; @esvs2025-editors].
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