This guidance refers to the use of endovascular stent–grafts or open surgical repair only for the treatment of infra-renal abdominal aortic aneurysms. This guidance should be read in conjunction with 'Stent–graft placement in abdominal aortic aneurysm' (NICE interventional procedure guidance 163).
1.1 Endovascular stent–grafts are recommended as a treatment option for patients with unruptured infra-renal abdominal aortic aneurysms, for whom surgical intervention (open surgical repair or endovascular aneurysm repair) is considered appropriate.
1.2 The decision on whether endovascular aneurysm repair is preferred over open surgical repair should be made jointly by the patient and their clinician after assessment of a number of factors including:
aneurysm size and morphology
patient age, general life expectancy and fitness for open surgery
the short- and long-term benefits and risks of the procedures including aneurysm-related mortality and operative mortality.
1.3 Endovascular aneurysm repair should only be performed in specialist centres by clinical teams experienced in the management of abdominal aortic aneurysms. The teams should have appropriate expertise in all aspects of patient assessment and the use of endovascular aortic stent–grafts.
1.4 Endovascular aortic stent–grafts are not recommended for patients with ruptured aneurysms except in the context of research. Given the difficulties of conducting randomised controlled trials, it is recommended that data should be collected through existing registries to enable further research.