Future Paradigms

in Future Directions in Vascular Surgery

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 ESVS AAA guidelines for the claim about total endovascular aortic surgery as the default approach. Per the stale guideline replacement instructions, wanhainen 2019 is replaced with 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. in the bullet point and the reference list entry is updated accordingly. The ACC/AHA 2022 guideline citation is retained alongside the ESVS 2024 guideline to maintain geographic balance for an international audience.

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.
Verified source
PubMedDOI

Content Changes

* **Total endovascular aortic surgery** as default [@wanhainen2019][@esvs2024-editors] [@aha2022-isselbacher-isselbacher].
* **[[endovascular**Endovascular trauma management (EVTM)]](EVTM) fully integrated into trauma care worldwide** [@horer2016] [@bulger2019].
* **Multidisciplinary aortic teams (MAT)** and the **hybrid vascular surgeon** (open + endovascular + artificial intelligence (AI) skills) as the new standard for complex aortic care [@mills2008] [@aha2022-isselbacher-isselbacher].
* **Predictive vascular medicine** using AI + genomics [@eur2020].
* **Expanded use of minimally invasive devices** even in emergency/field conditions [@morrison2014] [@bulger2019].
* **Shared decision-making (SDM)** as a fundamental requirement in the management of aortic disease to optimize patient-centered outcomes [@aha2022-isselbacher-isselbacher].

**References**

1. Patel VI, et al. Evolution of vascular surgery into an endovascular specialty. *J Vasc Surg*. 2017. PubMed
2. Powell JT, et al. Endovascular vs open repair of [[abdominal aortic aneurysm (AAA)]] – long-term results. *NEJM*. 2010. PubMed [@powell2010]
3. Wanhainen A, et al. ESVS 2024 Clinical Practice Guidelines on [[AAA]].the Management of Abdominal Aorto-Iliac Artery Aneurysms. *Eur J Vasc Endovasc Surg*. 2019.2024. PubMed[PubMed](https://pubmed.ncbi.nlm.nih.gov/38307694/) [@wanhainen2019][@esvs2024-editors]
4. Björck M, et al. ESVS 2025 Guidelines on Mesenteric and Renal Arteries. *Eur J Vasc Endovasc Surg*. 2025. [PubMed](https://pubmed.ncbi.nlm.nih.gov/40513642/) [@esvs2025]
5. Hörer TM, et al. [[EVTM]] paradigm in trauma and resuscitation. *J Trauma Acute Care Surg*. 2016. PubMed [@horer2016]
6. Mouawad NJ, et al. The role of robotics in vascular surgery. *Vascular*. 2020. PubMed [@mouawad2020]
7. Conte MS, et al. Global vascular guidelines on chronic limb-threatening ischemia. *J Vasc Surg*. 2019. PubMed [@conte2019-gvg]
8. Mani K, et al. The role of registries in vascular surgery (Swedvasc, Vascunet). *Eur J Vasc Endovasc Surg*. 2020. PubMed [@mani2020]
9. Daye D, Walker TG. Novel endovascular devices for peripheral interventions. *Tech Vasc Interv Radiol*. 2018. PubMed [@daye2018]
10. Loftus IM, et al. Future challenges in vascular surgery: global and societal perspectives. *Br J Surg*. 2021. PubMed
11. Isselbacher EM, et al. 2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease. *Circulation*. 2022. [PubMed](https://pubmed.ncbi.nlm.nih.gov/36322642/) [@aha2022-isselbacher-isselbacher]
Go to section in textbookDispute / Submit evidenceAll updates