Abdominal Aortic Aneurysm in Women and Men: A Systematic Review of Sex-Specific Outcomes in the United Kingdom

Women with AAA in the United Kingdom remain disadvantaged at every stage of care: they are less likely to be screened, rupture at smaller diameters, less often selected for repair, and when treated, face higher perioperative and long-term mortality. These disparities reflect a combination of anatomical and biomechanical differences, together with systemic factors. Current UK policy, based on male-only screening and a sex-neutral 5.5 cm threshold, does not reflect this reality. Sex-specific thresholds for repair, targeted female screening, and the development of devices optimized for female anatomy are needed to address inequity.