Aortic Aneurysm Over Time – Whether, When, and How to Treat

Over the past 30 years, the treatment of aortic aneurysms has evolved significantly from traditional open surgeries to less invasive endovascular methods, reducing perioperative burdens. Initially, surgeries were performed for aneurysms larger than 5 cm, but it was later found that the risk of rupture significantly increases at 5.5 cm for abdominal and 6 cm for thoracic aneurysms. Endovascular techniques, which became prominent in the 1990s, have minimized the need for large incisions and aortic clamping, thus reducing ischemic complications. The development of fenestrated and branched stent-grafts has further advanced treatment options, particularly for complex aneurysms. Looking forward, artificial intelligence is expected to enhance risk assessment and treatment planning, benefiting patients and society.