Part One: For the Motion. Young Patients with Good Risk Factors Should be Treated with EVAR

Abstract

There has been significant improvement in endovascular repair (EVAR) of infrarenal aortic aneurysms over the last 22 years, since Juan Parodi first reported on his historic cases. There are now several commercially available devices approved for EVAR throughout the world. Utilization of this technique for infrarenal abdominal aortic aneurysm (AAA) repair varies worldwide, but has been shown to be up to 80% of all AAA repairs done in the USA. Despite its widespread use in most patients, there are still subgroups in which the benefits of EVAR have not clearly been demonstrated. The subgroup most often debated is the young patient with good risk factors, which serves as the basis for the following debate. While initially thought to be a rare occurrence, this is an important controversy because in the USA more than 5,000 patients a year between the age of 50 and 64 years undergo aneurysm repair. There are substantial reasons why young patients with good anatomic characteristics and low comorbidities are very good candidates for EVAR, and it should be offered to this subgroup.