Follow-up

in Overview of Vascular Disease

Applied

Type

Modification

Confidence

92%

Created

Apr 14, 2026

Evidence

1 source

Rationale

The 2024 ESVS AAA guidelines (PMID 38307694) directly supersede the 2019 Wanhainen et al. ESVS guidelines for the claim regarding risk-stratified EVAR surveillance. Per the stale guideline replacement instructions, wanhainen 2019 is replaced with ESVS for this claim. The co-citation with Aburahma AF, Campbell JE, Mousa AY, et al is preserved as it supports a distinct aspect of the recommendation. All other section content and citations remain unchanged.

Evidence

ESVS. Editor's Choice -- European Society for Vascular Surgery (ESVS) 2024 Clinical Practice Guidelines on the Management of Abdominal Aorto-Iliac Artery Aneurysms. Eur J Vasc Endovasc Surg. 2024. PMID: 38307694. DOI: 10.1016/j.ejvs.2023.11.002.
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 duplex ultrasound (DUS) at 1 month, 12 months, then annually (European 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,[@esvs2024-editors, @aburahma2019]. Recent multicenter data supports the implementation of these updated algorithms, highlighting that 1-year sac dynamics (specifically sac shrinkage) are critical for predicting long-term stability and further refining the intensity of follow-up [@esposito2025].

Reviewer Notes

Approved after replacement-first stale-guideline regeneration review. Clean same-family replacement of stale guideline citation with the known 2024 ESVS AAA superseding guideline.

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