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Background <p>The treatment of abdominal aortic aneurysms (AAA) in Germany is subject to increasingly stricter regulation due to hospital structural reforms, minimum volume recommendations and quality assurance guidelines. The aim of this report is to provide a gender- and indication-stratified insight into the nationwide reality of care in 2024.</p> Method <p>This descriptive registry study reviews invasive AAA management using endovascular (EVAR) or open aortic repair (OAR) between 1 January 2024 and 31 December 2024. Data from 166 participating centers tracking 5207 patients (14.5% female) were included.</p> Results <p>A&#xa0;total of 4785 intact and 422 ruptured AAAs were treated. The median annual institutional caseload was&#xa0;21 for EVAR and 5 for OAR. For elective procedures, EVAR accounted for nearly 80% of cases, compared to approximately 43% in cases of ruptures. Notably, roughly 30% of elective procedures in women and 37% in men were performed below the established sex-specific diameter thresholds recommended by clinical guidelines. The in-hospital mortality after elective EVAR was 0.7% for men versus 2.3% for women; after elective OAR it was approximately 4% for both sexes. Following aortic rupture the in-hospital mortality was 52% in men and 60% in women.</p> Conclusion <p>The current registry report confirms a&#xa0;steady trend toward endovascular repair in elective settings, while open surgery maintains a&#xa0;substantial role in emergency rupture treatment. The results highlight significant sex-specific disparities in treatment reality and mortality. Furthermore, the high proportion of elective procedures performed below guideline-recommended diameter thresholds warrants further investigation and underscores the ongoing value of registry data for quality improvement and healthcare regulation.</p>

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Versorgung des Bauchaortenaneurysmas in Deutschland: Ein Bericht des Qualitätsregisters der DGG für das Jahr 2024

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年6月23日

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  • Jenny Lübcke,
  • Frederik Peters,
  • Livia Cotta,
  • Farzin Adili,
  • Matthias Trenner,
  • Christian-Alexander Behrendt

摘要

Background

The treatment of abdominal aortic aneurysms (AAA) in Germany is subject to increasingly stricter regulation due to hospital structural reforms, minimum volume recommendations and quality assurance guidelines. The aim of this report is to provide a gender- and indication-stratified insight into the nationwide reality of care in 2024.

Method

This descriptive registry study reviews invasive AAA management using endovascular (EVAR) or open aortic repair (OAR) between 1 January 2024 and 31 December 2024. Data from 166 participating centers tracking 5207 patients (14.5% female) were included.

Results

A total of 4785 intact and 422 ruptured AAAs were treated. The median annual institutional caseload was 21 for EVAR and 5 for OAR. For elective procedures, EVAR accounted for nearly 80% of cases, compared to approximately 43% in cases of ruptures. Notably, roughly 30% of elective procedures in women and 37% in men were performed below the established sex-specific diameter thresholds recommended by clinical guidelines. The in-hospital mortality after elective EVAR was 0.7% for men versus 2.3% for women; after elective OAR it was approximately 4% for both sexes. Following aortic rupture the in-hospital mortality was 52% in men and 60% in women.

Conclusion

The current registry report confirms a steady trend toward endovascular repair in elective settings, while open surgery maintains a substantial role in emergency rupture treatment. The results highlight significant sex-specific disparities in treatment reality and mortality. Furthermore, the high proportion of elective procedures performed below guideline-recommended diameter thresholds warrants further investigation and underscores the ongoing value of registry data for quality improvement and healthcare regulation.