This is a publication undertaken by a member of INAHTA, For further information please contact the agency using the contact details in the Correspondence Address field.

The aim of this review was to evaluate: - treatment options for nonruptured abdominal aortic aneurysms (AAA) - the relationship of hospital and physician volume to outcomes for endovascular repair (EVAR) - affect of patient and AAA factors on outcomes - cost-benefits of treatments

For AAA <5.5 cm in diameter, active surveillance with delayed OSR results in equivalent mortality but lesser morbidity and operative costs due to fewer interventions compared to immediate OSR. For AAA > or =5.5 cm, EVAR has not been shown to improve longterm survival or health status over OSR though peri-operative outcomes are improved. EVAR does not improve survival in patients who are medically unfit for OSR. EVAR is associated with more complications, need for reintervention, monitoring, and costs compared to OSR or no intervention. U.S. RCT are needed using approved EVAR devices to evaluate patient outcomes.