Surgical outcomes and indications for saccular abdominal aortic aneurysm repair: a systematic review

Indications for surgical repair of saccular abdominal aortic aneurysms lack satisfactory evidence, and the risk of rupture has been questioned. We conducted a systematic review assessing surgical outcomes following repair of this condition. Eight studies were included, totaling 540 patients. Endovascular repair was the most common approach. Complications occurred in 18.99% of the patients, and unfavorable surgical outcomes occurred in 3.15%, of which cardiac and pulmonary comorbidities were the most frequent. Aneurysms with smaller diameters presented fewer complications and unfavorable surgical outcomes than those with larger diameters. The ideal threshold for repair remains uncertain. Although diameter is an important indicator, other factors should be considered. These aneurysms should be treated electively at earlier stages due to their uncertain rupture risk and the higher prevalence of complications at larger diameters. Further research is needed to establish clear treatment guidelines for this condition.