An aneurysm is a permanent, restrictive dilatation of an artery. Although the diagnostic criteria for abdominal aortic aneurysms are not uniform, the vast majority of authors consider a limited dilatation of the artery greater than or equal to two times the normal diameter to be an aneurysm. The average CT measurement of infrarenal aortic diameter in adult men is 2.3 cm, whereas in women the corresponding diameter is only 1.9 cm. Therefore, a diagnosis of abdominal aortic aneurysm should be made at 4 cm as a starting point. The size of the aneurysm is commonly expressed as the maximum external transverse diameter of the aorta (measured by ultrasound, CT, MRI or directly during surgery). Most studies report that abdominal aortic aneurysms grow at a rate of 1-9 mm/year, with an average of approximately 4 mm/year. Larger aneurysms generally enlarge more rapidly. Some aneurysms may remain stable and not grow over time, while others expand progressively. An important factor associated with aneurysm expansion and rupture is the size of the aneurysm. Other factors that can contribute to enlargement are hypertension, obstructive lung disease, and renal insufficiency. The decision to operate should be made when the risk of death from abdominal aortic aneurysm exceeds the risk of surgery, which is proportional to the arterial wall tension and its lumen diameter according to Laplace’s law. In this way, rupture of larger aneurysms is more common than rupture of smaller aneurysms. Studies of the natural course of abdominal aortic aneurysms have found that rupture of small aneurysms can occur but is rare. Current data suggest that the 5-year incidence of rupture in 4-5 cm aneurysms is 25%. Aneurysms of 5-6 cm have a 5-year rupture rate of nearly 35%, and aneurysms of 7 cm or greater have a 5-year rupture rate of more than 75%. For patients with abdominal aortic aneurysms, aneurysms of 4.5 cm or greater in diameter should, in principle, be operated on. Once there are painful symptoms, tends to rupture, or the aneurysm compresses adjacent tissues or forms entrapment, early surgery should be performed. Currently, the surgical mortality rate of elective conventional abdominal aortic aneurysm resection has been controlled to less than 5%, but for high-risk patients with combined heart, brain, lung and kidney diseases, the mortality rate of conventional open surgery can be as high as 60%. Since 1991, when Parodi reported the use of endoluminal artificial endovascular support for abdominal aortic aneurysms, the use of endoluminal vascular surgery has increased as a promising new minimally invasive technique in the field of vascular surgery. With the advancement of endoluminal technology, the minimally invasive procedure of endoluminal repair (EVAR) is increasingly used in clinical practice. For patients with high-risk abdominal aortic aneurysm with combined cardiopulmonary and renal diseases, endoluminal prosthetic endovascular support is preferred for its advantages of less trauma, less blood loss, and faster recovery.