Endovascular abdominal aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA) has been an alternative surgical treatment due to its low perioperative mortality and morbidity rates. However, mid- and long-term follow-up results of randomized, controlled trials have shown that the early survival advantage of EVAR is lost by four years, and open surgery has a survival benefit at between 8 and 15 years. These results indicate an increase in aneurysm-related mortality and complications in the EVAR group. Concerns about the long-term durability of EVAR have become a significant issue worldwide in recent years. Meanwhile, with the evolution of devices, there is also a trend to expand the use of EVAR in patients with more complex anatomical structures. What should clinicians do to stabilize the durability of EVAR? First, we need to identify the risk factors that affect the durability of EVAR based on published data. Second, we should consider appropriate patient selection, device selection, and perform surgical procedures.
