Follow-up

in Overview of Vascular Disease

Applied

Type

Reinforcement

Confidence

85%

Created

Mar 27, 2026

Evidence

1 source

Rationale

The new article (Esposito 2025) provides high-quality multicenter validation for the existing ESVS EVAR surveillance guidelines. It specifically highlights 'sac dynamics' at 1 year as a critical factor for determining which patients can safely transition to less intensive follow-up. I integrated this by expanding the existing paragraph on risk-stratified surveillance. I also expanded abbreviations (DUS, ESVS, SVS) on their first use in the section as per the instructions.

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,(European SVS)Society for Vascular Surgery (ESVS), Society for Vascular Surgery (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 evidence validates the safety of the ESVS algorithm, emphasizing that 1-year sac dynamics—specifically sac shrinkage—is a reliable predictor for safe long-term de-escalation of surveillance in low-risk patients [@esposito2025-b].
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