Landmark Paper Series: Abdominal Aortic Aneurysm

Welcome back to the Audible Bleeding Series: Landmark Papers in Vascular Surgery. In this episode, Audible Bleeding editor John Culhane and co-host Dr. Jesse Columbo are joined by our guests, Dr. David Stone, Dr. Salvatore Scali, and Dr. Anders Wanhainen to unpack one of the longest-running debates in aortic surgery: when (and whether) to repair an abdominal aortic aneurysm.

We'll start our episode with the open-repair era and the two trials that set the basis for the 5.5 cm threshold—UKSAT and ADAM—then move into the early EVAR years with PIVOTAL and CAESAR, which asked whether fixing smaller aneurysms with endovascular technology could do better. Finally, we'll look at how modern screening programs, improved medical therapy, and current guidelines have reshaped the practical decisions we make for these patients every day.

Links to Papers Discussed:

Open Surgery Era

1. UKSAT (1998)

2. ADAM (2002)

Endovascular Era

1. PIVOTAL (2010)

2. CAESAR (2012)

Contemporary Results

1. Oliver-Williams/NHS NAAASP

2. Rokosh/SVS Guidelines

3. ESVS 2026 Guidelines

Guests:

Dr. David Stone, MD (@DHStoneMD); Dartmouth

Dr. Salvatore Scali, MD (@UFVascular); University of Florida

Dr. Anders Wanhainen, MD, PhD (@AWanhainen); Uppsala University, Sweden

Hosts:

John Culhane, MD (@JohnCulhaneMD); Vascular Surgery Fellow, Montefiore

Dr. Jesse Columbo, MD; Dartmouth

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