Follow-up

in Overview of Vascular Disease

Applied

Type

Reinforcement

Confidence

80%

Created

Mar 27, 2026

Evidence

1 source

Rationale

The new article by Esposito et al. (2025) provides high-quality multicenter validation for the risk-stratified EVAR surveillance protocols already mentioned in the text. By specifically identifying 1-year sac shrinkage as a key predictor for long-term success, it strengthens the argument for de-escalating surveillance in stable patients. I integrated this finding into the final paragraph to reinforce the existing guidelines. I also expanded the abbreviation 'DUS' on its first occurrence as required.

Evidence

Esposito D, et al. Implementation of the Updated European Society for Vascular and Endovascular Surgery Proposed Endovascular Aneurysm Repair Surveillance Algorithm in a Multicentre Cohort with a Minimum Five Year Follow Up Adherence: Further Improvement of Results via 1 Year Sac Dynamics. Eur J Vasc Endovasc Surg. 2025. PMID: 40216188.
Verified source
PubMedDOI

Content Changes

Surveillance ensures early detection of complications such as graft stenosis, endoleaks, and restenosis.

* **endovascular aneurysm repair (EVAR):** computed tomography angiography (CTA) or DUSduplex ultrasound (DUS) at 1 month, 12 months, then annually (ESVS, SVS) [@evar2019].
* **Open abdominal aortic aneurysm (AAA) repair:** Imaging only if symptomatic.
* **Bypass grafting:** DUS at 1–3, 6, 12 months, then annually [@almasri2018].
* **Carotid (carotid endarterectomy (CEA)/carotid artery stenting (CAS)):** DUS at 6 months, then every 1–2 years [@esvs2018-esvs].
* **Venous intervention:** DUS at 1–3 months, then as clinically indicated.

For EVAR, risk-stratified surveillance per ESVS AAA guidance suggests that many standard EVARs may transition to duplex-based annual follow-up after a stable first-year scan, while complex anatomies or endoleaks require individualized schedules [@wanhainen2019, @aburahma2019]. Recent multicenter data reinforces this approach, demonstrating that aneurysm sac shrinkage at 1 year is a robust predictor of long-term stability, further justifying the implementation of reduced-intensity surveillance algorithms for low-risk patients [@esposito2025-esposito].
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