Bulder RMA, Talvitie M, Bastiaannet E, et al. - Researchers here examined how the changes in elective abdominal aortic aneurysm (AAA) management have affected life-expectancy of AAA patients. They performed national evaluation including all 12.907 (82.7% male) patients who underwent elective AAA repair from 2001 to 2015 in Sweden. Based on 3 timeframes, a time-resolved analysis was conducted to determine the impact of changes in AAA management: open repair dominated period (2001–2004, n = 2,483), transition period (2005–2011, n = 6,230), and EVAR-first strategy period (2012–2015, n = 4,194). Although reduction in short-term mortality occurred in correlation with the changes in elective AAA management, there was no improvement in the profound long-term survival disadvantage of AAA patients. Given the persistent high (cardiovascular) mortality, they emphasize further intensification of cardiovascular risk management, and a critical evaluation of the basis for the excess mortality of AAA patients.