Trends and Scientific Evolution in Endovascular Aneurysm Repair (EVAR) Research: A Comprehensive Bibliometric Study Using Vosviewer

Abstract

Background: Endovascular aneurysm repair (EVAR) has become a standard treatment for abdominal aortic aneurysms. However, the evolution of EVAR research and its global landscape remain underexplored. This bibliometric analysis aims to map publication trends, identify key contributors, and analyze thematic shifts in EVAR literature over the past three decades.Methods: Data were collected from the Web of Science Core Collection (SCIE) in May 2025. A total of 4264 original research articles on EVAR were analyzed using VOSviewer for co-authorship, co-citation, and keyword co-occurrence mapping. Citation trends, geographical distribution, and institutional contributions were also assessed.Results: Research on EVAR showed steady growth, with a peak of 295 publications in 2024. The United States contributed the largest share (33.02%) of publications. Prolific authors such as Schermerhorn and Verhagen, affiliated with leading institutions like Harvard University, played a pivotal role in advancing the field. Keyword analysis revealed a shift from technical terms (e.g., "stent graft") to clinical outcomes (e.g., "reintervention") over time. The integration of artificial intelligence (AI) in EVAR research is emerging as a key focus area.Conclusion: This study highlights the growth and evolving focus of EVAR research, with a notable shift toward patient-centered outcomes. Despite strong contributions from high-income countries, there is a significant gap in research from low-resource settings. Future directions should include addressing gaps in radiation safety, emergency EVAR applications, and exploring AI-driven clinical decision-making for personalized treatments. Complex EVAR research continues expanding, reflecting guideline evolution and advancing practice in anatomically challenging cases.Clinical Impact This bibliometric analysis demonstrates how EVAR has progressed from an emerging minimally invasive technique to a guideline driven standard of care, with a growing emphasis on complex fenestrated and branched procedures. For clinicians, the findings clarify where the evidence base is well established, particularly for standard infrarenal EVAR, and where further caution and innovation are required, including complex anatomies, long term durability, and reintervention risk. By synthesizing influential studies, key guideline milestones, and evolving research themes, this study supports evidence based clinical decision making, improves patient counseling, and reinforces the importance of lifelong surveillance. Its innovation lies in translating three decades of global research into clinically actionable insight.