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High quality vascular surgical registries were established early and have been found to be instrumental in the evaluation and monitoring of these changes, most notably the wide implementation of minimally invasive endovascular surgical technology. Trends over the years showed the increased use of endovascular aneurysm repair (EVAR) over open repair, the decreasing perioperative adverse outcomes and the early survival advantage of EVAR. Also, data from the early EVAR years changed the views on endoleak management and showed the importance of tracking the implementation of new techniques. Registry data complemented the randomized trials performed in aortic surgery by showing the high rate of laparotomy\u2010related reinterventions after open repair. Also, they are an essential tool for the understanding of outcomes in a broad patient population, evaluating the generalizability of findings from randomized trials and analysing changes over time. By using large\u2010scale data over longer periods of time, the importance of centralization of care to high\u2010volume centres was shown, particularly for open repair. Additionally, large\u2010scale databases can offer an opportunity to assess practice and outcomes in patient subgroups (e.g. treatment of AAA in women and the elderly) as well as in rare aortic pathologies. In this review article, we point out the most important paradigm shifts in AAA management based on vascular registry data.<\/jats:p>","DOI":"10.1111\/joim.13051","type":"journal-article","created":{"date-parts":[[2020,3,2]],"date-time":"2020-03-02T11:54:17Z","timestamp":1583150057000},"page":"38-50","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Paradigm shifts in abdominal aortic aneurysm management based on vascular registries"],"prefix":"10.1111","volume":"288","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5282-1204","authenticated-orcid":false,"given":"L.","family":"de Guerre","sequence":"first","affiliation":[{"name":"Division of Vascular Surgery and Endovascular Therapy Beth Israel Deaconess Medical Center Boston MA USA"},{"name":"Department of Vascular Surgery University Medical Center Utrecht Utrecht The 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