Was Sie schon immer zur Behandlung des abdominalen Aortenaneurysmas in Deutschland wissen wollten: Real-World-Evidenz, Trends und offene Fragen

Although there is a paucity of valid population-based data concerning the prevalence and incidence of abdominal aortic aneurysms (AAA) in Germany, national screening studies in Sweden, the USA, and England suggest a prevalence of AAA of 1.5–3.6% among males over 65 years old. The treatment of patients with AAA in Germany is provided by multiple disciplines and healthcare sectors, whereby approximately 12,000 invasive procedures to treat intact (90%) and ruptured AAA are performed annually. In line with international treatment reality 70% of intact and 30% of ruptured AAA are treated endovascularly (EVAR). Data from various administrative and clinical registers on in-hospital mortality confirm the results from randomized trials and meta-analyses with 1% after elective EVAR through 5% after elective open repair (26% and 42% after ruptured AAA, respectively). In Germany, more than 500 hospitals treat patients with AAA. A significant correlation between annual case volume and lower in-hospital mortality was confirmed based on various data sources. A threshold of 30 AAA repairs per year seems reasonable with respect to the accessibility of hospitals. Despite the many available studies and presence of the topic in scientific journals and scientific meetings, many questions remain unanswered to date.