Background— Treatment of abdominal aortic aneurysm (AAA) has changed significantly over the past 2 decades. In this perspective, time trends in long-term survival were studied. Methods and Results— We identified 8663 primary intact and 4171 ruptured AAA repairs in the Swedish Vascular Registry from 1987 to 2005. Mortality was obtained from the national population registry. Crude survival was analyzed, including all mortality. To analyze the long-term outcome among those surviving the AAA repair, relative survival, which denotes the survival rate of patients compared with that of the general population adjusted for age, sex, and calendar year, was calculated, excluding 90-day mortality. In a comparison of AAA repairs from 1987 to 1999 and 2000 to 2005, age (71.4 versus 72.5 years; P <0.001), patients with comorbidities (65.0% versus 68.5%; P <0.001), and endovascular repair (1.6% versus 17.0%; P <0.001) increased. After intact AAA repair, crude 5-year survival was 69.0% (99% confidence interval [CI], 67.7 to 70.4), and relative 5-year survival excluding 90-day mortality was 90.3% (99% CI, 88.6 to 92.0). Relative 5-year survival was better for those operated on from 2000 to 2005 compared with 1987 to 1999 (difference, 4.7%; 99% CI, 1.3 to 8.1), for men versus women (4.6%; 99% CI, 0.4 to 8.8), and for octogenarians versus patients <80 years of age (10.2%; 99% CI, 1.5 to 18.8); no difference was observed between open and endovascular repair (6.0%; 99% CI, −1.5 to 13.4). After ruptured AAA repair, crude 5-year survival was 41.7% (99% CI, 39.6 to 43.7) and relative 5-year survival was 87.1% (99% CI, 83.9 to 90.3). No significant differences in relative 5-year survival were observed between time periods, sex, or age groups. Conclusions— Long-term survival improved over time after intact AAA repair despite a change in case mix toward older patients with more comorbidities. Long-term survival was stable after ruptured AAA repair.

Background: Treatment of abdominal aortic aneurysm (AAA) has changed over time, with endovascular repair (EVAR) being the main technical revolution. This study assessed the effect of this change on outcome on a national basis over a 17-year interval. Methods: Primary infrarenal AAA repairs in Swedish residents aged 50 years and older, in the Swedish Vascular Registry (Swedvasc) 1994–2010, were analysed. The rate per 100 000 population, patient characteristics, operative technique and outcome were assessed for the intervals 1994–1999, 2000–2005 and 2006–2010. Results: Some 11 336 intact aneurysm repairs were performed. The overall rate per 100 000 increased (18·4 in 1994–1999, 19·4 in 2000–2005 and 24·0 in 2006–2010; P < 0·001), most noticeably among older people (18 per cent increase among those aged 50–64 years, P = 0·004; 27 per cent in 65–79-year-olds, P < 0·001; 128 per cent in those aged at least 80 years, P < 0·001). The use of EVAR increased rapidly after 2005 (rate: 0·6 in 1994–1999, 4·4 in 2000–2005 and 11·8 in 2006–2010; P < 0·001). The 30-day mortality rate decreased after open repair (4·7, 3·4 and 2·7 per cent respectively; P < 0·001), but was stable after EVAR (2·6, 2·2 and 1·6 per cent; P = 0·227). Some 4972 ruptured aneurysm (rAAA) repairs were performed. The rate decreased after 2005 (9·3 in 1993–1999, 9·3 in 2000–2005 and 8·4 in 2006–2010; P = 0·006). The use of EVAR for rAAA increased over time (rate: 0, 0·5 and 1·6 respectively; P < 0·001), whereas open repair decreased (9·3, 8·8 and 6·8; P < 0·001). Thirty-day mortality decreased over time (38·3, 32·8 and 28·4 per cent; P < 0·001). Conclusion: The introduction of EVAR has been associated with an increased number of intact AAA repairs, which has accelerated recently, whereas the rate of rAAA repair has started to decline. Simultaneously, outcomes have improved.

Manuscripts submitted to the European Journal of Vascular and Endovascular Surgery (EJVES) often contain shortcomings in baseline scientific principles and incorrectly applied methodology. Consequently, the editorial team is forced to offer post hoc repair in an attempt to support the authors to improve their manuscripts. This repair could theoretically have been prevented by providing more clear definitions and reporting standards to serve researchers when planning studies and eventually writing their manuscripts. Therefore, here we summarise the general principles for EJVES reporting standards. These reporting standards did not follow a systematic approach but reflect the common opinion of the current senior and section editors team. This team decided to only include recommendations regarding the most common pathologies in vascular surgery in this first edition of reporting standards, namely carotid artery disease, abdominal aortic aneurysm (AAA), peripheral arterial occlusive disease (PAOD), and chronic venous disease. In future editions, we plan to expand the areas of research. We present (1) a common set of minimum but required reporting standards applicable to every report, e.g., patient characteristics, study design, treatment environment, selection criteria, core outcomes of interventions such as 30 day death and morbidity, and measures for completeness of data including outcome information, and (2) a common set of minimum reporting standards for four vascular areas. The editors of the EJVES propose universally accepted definitions and reporting standards for carotid artery disease, AAA, PAOD, and chronic venous disease. This will enable the development of a convincing body of evidence to aid future clinical practice guidelines and drive clinical practice in the right direction. These first ever publication and reporting standards for EJVES aim to improve future research in our journal.